Claims Analyst

Role Description

The Claims Analyst is responsible for managing billing and collections across multiple facilities, ensuring compliance with payor requirements, and maintaining accurate accounts receivable. This role also supports staff in following financial processes and collaborates with internal departments to ensure timely and accurate reimbursement activities.

How you’ll contribute as a Claims Analyst who excels in this role:

• Accurately performs billing and collections for multiple facilities for all payors.
• Provides professional and technical support to staff across multiple departments.
• Responds to inquiries from insurance carriers, patients, and family members regarding billing and account balance questions.
• Monitors and reviews financial systems to ensure accurate revenue recognition and maintain appropriate accounts receivable levels aligned with payer mix and acuity.
• Collaborates with Utilization Management departments to ensure pre-certifications, authorizations, and appeals are completed accurately and on time.
• Performs effective and timely follow-up on insurance claims to secure appropriate reimbursement.
• Analyzes explanations of benefits (EOBs), remittances, and explanations of payment (EOPs) to identify discrepancies or underpayments.
• Researches and resolves claim issues.
• Prepares, submits, and tracks appeals for denied claims through resolution.
• Prepares for and actively participates in weekly Accounts Receivable (AR) meetings.

Qualifications

• High school diploma required; Associate degree preferred.
• 3–5 years of computerized medical billing experience required; behavioral healthcare experience preferred.
• Working knowledge of Medicare/Medicaid and institutional billing requirements.

Requirements

• Strong knowledge of Medicare/Medicaid guidelines and UB04 billing requirements.
• Proficiency in computerized medical billing systems.
• Ability to manage multiple facilities and payor types simultaneously.
• Strong analytical and problem-solving skills.
• Effective communication with internal teams and external stakeholders.
• Detail-oriented with strong organizational skills.
• Ability to work in a fast-paced, high-volume, production-based environment.
• Understanding of Hospital Revenue Cycle processes within a multi-facility healthcare environment.

Benefits

• Comprehensive Benefits: Multiple levels of medical, dental, and vision coverage for full-time and part-time employees.
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave, and paid time off.
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance, and 401(k) retirement package with company match.
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services, and discount programs).
• Professional Development: Ongoing learning and career advancement opportunities.

Company Description

Lifepoint Health is a leader in community-based care and is driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes:

• 63 community hospital campuses
• 32 rehabilitation and behavioral health hospitals
• More than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers, and post-acute care facilities.

We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.

We employ and provide care to people from all walks of life. We are committed to promoting healing, providing hope, preserving dignity, and producing value with an inclusive workforce in which diversity is leveraged, respected, and reflective of the patients, family members, customers, and team members we serve.