All Pointe HomeCare, A/R Follow Up Specialist - Full Time - Various Locations, CT

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Ar Specialist

About Us

All Pointe HomeCare was founded in 2011 by home care veterans Steve and Nancy LaPointe. Over the years, All Pointe HomeCare has significantly grown and proudly offers a staff of reliable and experienced RNs, LPNs, and Home Health Aides who are readily available for short and long-term assignments within the home. Today, All Pointe HomeCare employs over 250 highly trained health care providers throughout the state of Connecticut.

In October of 2024, All Pointe HomeCare proudly became a subsidiary of Connecticut Children’s. With this strategic move, Connecticut Children’s now has the ability to offer a full spectrum of care, from hospital to home, ensuring that children can receive vital medical attention in a comfortable, familiar setting. Both private in-home nursing and skilled, intermittent care is available in many geographic areas throughout the state of Connecticut. This expansion not only strengthens the continuity of care but also helps to reduce discharge delays, allowing children to transition seamlessly from hospital to home with ongoing medical support.

With the addition of more than 250 highly trained home health aides, nurses, and clinicians from All Pointe HomeCare, Connecticut Children’s is now able to serve over 200 children requiring both short-term and long-term homecare. This expansion also positions the health system to better support children with acute and chronic complex medical needs, including respiratory care and tube feeding, in their homes.

Position Summary

The AR Specialist-Homecare position is responsible for managing all facets of the homecare accounts receivable to ensure timely and accurate billing, collections, and account resolution. This role encompasses billing operations, proactive follow-up on outstanding balances, effective denial management, accurate cash application, and coordination of appeals and other activities essential to optimizing revenue recovery. The specialist works collaboratively with internal teams and external payers to resolve discrepancies, improve cash flow, and maintain compliance with company and regulatory requirements.

Responsibilities

Billing

• Generate and submit accurate patient claims to insurance companies and government payers, ensuring compliance with healthcare regulations and coding standards. Claims are generated electronically for submission or keyed directly into the payor portal as needed.
• Review the unbilled report daily to release claims in backlog that need to be billed; communicate with accountable stakeholders to ensure issues are resolved to allow billing
• Collaborate with Scheduling, compliance, coding, and clinical staff to ensure proper documentation and accurate charge capture.
• Perform all client and school billing as needed for services provided.
• Perform direct patient billing and generate invoices for patient liabilities as needed.

Ar Follow-Up/Denial Management

• Follow up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax, or websites.
• Analyze accounts receivable aging reports to prioritize collection efforts and identify trends that impact cash flow.
• Investigate discrepancies between payments and billed amounts, identifying issues such as coding errors, missing documentation, or coverage limitations.
• Identify root causes of insurance denials. Review and analyze denied or rejected claims to determine the reasons for denial and develop appropriate strategies for resolution.
• Gather and organize necessary documentation such as medical records, billing information, and patient authorization forms to support the appeal.
• Prepare and submit formal appeal letters or requests to insurance companies, government payers, or third-party organizations following payer guidelines and deadlines.
• Follow up promptly on unresolved appeals to escalate issues and facilitate timely resolution.
• Remain current with core knowledge of specific payer policies, contracts, and administrative bulletins.

Cash Application

• Apply payments and adjustments accurately to patient accounts, ensuring that payments match contractual agreements and patient billing records.
• Review and interpret Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) to ensure payments are applied correctly (manually or electronically).
• Identify and research discrepancies or errors in payment postings and coordinate with billing, collections, or insurance representatives to resolve issues.
• Contact payors directly for check discrepancies or ERA/EFT conversion requests
• Complete balancing and reconciliation daily
• Ensure unapplied payments are resolved monthly and per department goals.

Other Operational Duties

• Maintain detailed documentation and records of all billing, payment, and follow-up activities to support audits and compliance requirements.
• Coordinate and manage home care audits, ensuring compliance with regulations and maintaining accurate records. 
• Assist with month-end and year-end reporting related to accounts receivable and revenue cycle metrics.
• Ensure strict adherence to HIPAA regulations and patient confidentiality standards in all billing and collection activities.
• Identify opportunities for process improvements within the revenue cycle to increase efficiency and reduce days in accounts receivable.
• Communicate professionally with patients, insurance carriers, and internal departments to clarify billing issues and resolve account discrepancies.
• Develop documentation and training workflows related to billing, AR/follow-up, and denials for the department.
• Participate in the development of policies and procedures to improve department workflow and the claims process, ensuring proper documentation.
• Attend applicable meetings, including payer meetings as appropriate.
• Process inbound patient accounting-related mail for correspondence, checks, etc, and work as needed.
• Performs other job-related duties as assigned.

Organizational Structure

Reports to (Job Title): Manager Billing & AR Follow Up Supervisory Responsibility (Yes/No): No Job titles reporting into role: n/a Number of Direct Reports n/a Number of Indirect Reports n/a

Qualifications

• High School Diploma or GED. Associate’s Degree in Healthcare Management, Finance, or related field preferred.
• Minimum of 5 years of Billing, Accounts Receivable, and Denial Management experience in healthcare required. Specialization in home healthcare billing preferred. Experience must include the billing of Medicare and Medicaid.

KNOWLEDGE, SKILLS, and ABILITIES

• Knowledge of billing and revenue cycle functions with specialization in AR follow-up, including but not limited to: claims submission, denials, and adjudication, transaction reviews, adjustment posting, and identification of patient responsibility
• Knowledge of home care audits, regulations, and compliance requirements
• Knowledge of medical terminology, diagnosis and procedure codes, and disability duration guidelines
• Knowledge of coverage criteria guidelines for insurance coverage, as well as the insurance verification process
• Knowledge of working payor denials and the appeal process
• Knowledge of Explanation of Benefits (EOBs) and Electronic Remittance Advice (ERA) to reconcile payments properly
• Basic accounting skills for balancing and reconciling accounts.
• Knowledge of Microsoft Office suite, specifically MS Word and Excel 
• Knowledge of QuickBooks
• Knowledge of Continulink is highly desired
• Excellent verbal and written communication skills for liaising with payers and patients
• Detail-oriented with high accuracy in reviewing and reconciling accounts
• Collaborative team player who works well across departments
• Ability to analyze accounts receivable aging reports and financial data
• Strong problem-solving skills and ability to handle complex accounts.
• Ability to work independently and as part of a team.
• Effective time management and multitasking abilities.
• Able to prioritize work and adapt to new workflows and processes 

Connecticut Children’s is the only health system in Connecticut that is 100% dedicated to children. Established on a legacy that spans more than 100 years, Connecticut Children’s offers personalized medical care in more than 30 pediatric specialties across Connecticut and in two other states. Our transformational growth establishes us as a destination for specialized medicine and enables us to reach more children in locations that are closer to home. Our breakthrough research, superior education and training, innovative community partnerships, and commitment to diversity, equity and inclusion provide a welcoming and inspiring environment for our patients, families and team members.
At Connecticut Children’s, treating children isn’t just our job – it’s our passion. As a leading children’s health system experiencing steady growth, we’re excited to expand our team with exceptional team members who share our vision of transforming children’s health and well-being as one team.