Claims Analyst- Remote
LifePoint Health
Job Description Schedule: Days: M-F Job Location Type: [ Remote] Your experience matters At Lifepoint Health, we are committed to empowering and supporting a diverse and determined workforce who can drive quality, scalability, and significant impact across our hospitals and communities. As a member of Springstone Behavioral Health team, you'll support those that are in our facilities who are interfacing and providing care to our patients and community members to positively impact our mission of making communities healthier ®. More about our team 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 follows financial processes, and collaborates with internal departments to ensure timely and accurate reimbursement activities. How you'll contribute A Claims Analyst who excels in this role:
Applicants should have a high school diploma required; Associate degree preferred with 3-5 years of computerized medical billing experience required with behavioral healthcare experience preferred and working knowledge of Medicare/Medicaid and institutional billing requirements.
Additional requirements include:
- Accurately performs billing and collections for multiple facilities for all payors.
- Provide professional and technical support to staff across multiple departments.
- Respond to inquiries from insurance carriers, patients, and family members regarding billing and account balance questions.
- Monitor and review financial systems to ensure accurate revenue recognition and maintain appropriate accounts receivable levels aligned with payer mix and acuity.
- Collaborate with Utilization Management departments to ensure pre-certifications, authorizations, and appeals are completed accurately and on time.
- Perform effective and timely follow-up on insurance claims to secure appropriate reimbursement.
- Analyze explanations of benefits (EOBs), remittances, and explanations of payment (EOPs) to identify discrepancies or underpayments.
- Research and resolve claim issues
- Prepare, submit, and track appeals for denied claims through resolution.
- Prepare for and actively participate in weekly Accounts Receivable (AR) meetings.
- 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 and 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.
Applicants should have a high school diploma required; Associate degree preferred with 3-5 years of computerized medical billing experience required with behavioral healthcare experience preferred and working knowledge of Medicare/Medicaid and institutional billing requirements.
Additional requirements include:
- 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
Vacancy posted more than 2 months ago
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