Underpayment Medical Analyst - Remote | WFH

We are seeking a skilled and detail-oriented Healthcare Reimbursement Specialist to join our team. In this role, you will play a vital part in the insurance follow-up process and contribute to the efficiency of our healthcare reimbursement methodologies. Please note that the company name has been omitted for privacy reasons.
Key Responsibilities...
Understanding of Insurance Follow-Up Process: Demonstrate a solid working knowledge of the insurance follow-up process, coupled with a comprehensive understanding of fundamental concepts in healthcare reimbursement methodologies.
Managed Care Expertise: Possess detailed knowledge of Managed Care reimbursement methodologies to ensure accurate and efficient processing.

Payment Variance Analysis: Conduct thorough payment variance analysis to identify trends in underpaid claims, ensuring financial accuracy.

Special Projects and Duties: Engage in special projects, utilizing Excel spreadsheets, and effectively communicate project results. Take initiative in assisting with various duties as needed.

Underpayment and Denial Trends: Identify, document, and report underpayments and denial trends, taking proactive measures to initiate appeals when necessary.

Healthcare Claims Processing: Demonstrate basic knowledge of healthcare claims processing, including ICD-9, CPT, and HCPC codes.

Issue Resolution: Analyze, identify, and resolve issues causing payer payment delays, with a focus on addressing billing and coding errors.

Information Security and HIPAA Compliance: Understand and comply with Information Security and HIPAA policies and procedures at all times. Use, protect, and disclose patients' protected health information (PHI) in accordance with HIPAA standards.

Security Reporting: Report any security or HIPAA violations or concerns promptly to the HIPAA Officers.

Qualifications

Experience: Minimum of 2 years' experience in Commercial insurance collections, including submitting and following up on claims. Experience in Physician billing is a plus.

Team Collaboration: Ability to work effectively both individually and as part of a collaborative team.

Technical Proficiency: Proficient in MS Office, with a particular emphasis on Excel.

Adaptability: Ability to adapt to learning various payer contracts, client billing systems, and government regulations.

If you are a dedicated professional with a passion for healthcare reimbursement and an eagerness to contribute to a dynamic team, we invite you to apply for this exciting opportunity. Join us in making a positive impact on the healthcare industry.

Employment Type: Full-Time

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