Insurance Analyst I-Patient Financial Services

Job Details Default Work Shift: Day (United States of America) | Hours: 40 | Salary range: $0.00 - $0.00 | Schedule: Full Time | Shift Hours: 8 Hour employee | Department: Patient Financial Services | Reports To: Director Job Objective Performs account review, follow-up and collections to include double recoupment, correspondence and credit balance resolution. Education & Qualifications High school diploma, GED or higher level degree (Required) One (1) year of billing/collections experience, billing certification or prior successful internship/temporary assignment in a patient financial service setting (Required) Experience with managed care and Medicare/Medi-Cal Billing regulations (Preferred) Essential Responsibilities Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations. Manages new accounts, on a daily basis, by working within Receivables Workstation; interfaces with other departments to obtain necessary information to process or resolve claims; contacts patient and/or account guarantor to solicit payment on account. Works all accounts listed in the Follow‑Up queue on a daily basis to promote collection of accounts; includes telephoning the payer, messaging or identifying the claim on the payer’s Internet websites. Manages account inventory on a timely basis to promote payment and resolution of all accounts as instructed by management. Stays current on all payer requirements by reading bulletins, reviewing provider handbooks, accessing websites, etc. Processes incoming correspondence, including signature letters, denials, prior authorizations and additional information necessary to process the claim. Records newly identified insurance plans and facilitates the account processing of new plan in accordance with pre‑billing policies and procedures. Records accurate and definitive notes in the electronic account file that depict the current status of account, issues with account and anticipated date of resolution. Escalates account management to leadership when issues arise, if needed. Ensures leadership is kept up to date with contract, payer or system changes and/or issues. Assigns a status code to each worked account to enable account tracking, statistical data gathering and audit activities. Manages new credit balance accounts every day and prepares adjustments or refunds to zero the account balance. Handles special projects as directed by leadership (e.g., high dollar accounts, accounts over 180 days old, etc.). Attends in‑house training and attends classes pertaining to Federal and State billing regulations as well as Compliance Issues and Guidelines as requested. Maintains productivity standards by payer assignment. Performs other duties as assigned. Other Information Blood Borne Pathogens: Minimal/No Potential | Skills, Knowledge, Abilities: Ability to handle multiple projects/tasks at the same time and prioritize workload; Ability to interpret payer contracts and federal and state regulatory guidelines; Ability to operate basic office equipment (copiers, fax machines, calculators); Ability to prioritize tasks and manage time efficiently to meet deadlines; Knowledge of computer‑based claims management; Knowledge of database systems and internet applications; Knowledge of Medical Terminology; Strong customer service and problem‑solving skills; Strong Windows knowledge and keyboarding skills. Additional Context This position is located within Patient Financial Services and is fully salaried, with a scheduled work shift during daytime hours in the United States. The role reports directly to the Director and requires a strong emphasis on compliance, payer interaction, and credit balance management. #J-18808-Ljbffr