Insurance Claims Analyst – Full Time (Benefit Eligible)
Primary Objective:
Maintain accounts receivable at Insurance Department standards and monitor reimbursement from payers to ensure accurate payment levels.
Responsibilities:
- Maintain accounts receivable of greater than 120 days at 7% or below.
- Process insurance correspondence on a daily basis.
- Perform necessary follow-up to resolve unpaid/rejected claims.
- Submit appeals on denied claims when appropriate.
- Monitor accounts receivable age.
- Examine insurance claims and EOB’s for accuracy.
- Research and correct rejected claims with clearing house.
- Serve as liaison between CRL and assigned insurance company(ies).
- Additional responsibilities as assigned by management.
Qualifications:
- Minimum one year experience in provider billing processing
- Experience with and general knowledge of industry-standard forms and files, such as: CMS 1500, EOB’s, EDI 835’s and 837’s, etc.
- Basic CPT and ICD10 coding knowledge and familiarity with medical terminology.
- Experience using EPIC and using Healthia (or other eligibility verification tools), is preferred.
- Demonstrated ability to work well in a team-oriented environment.
- Excellent communication and organizational skills, detail-oriented, and ability to learn quickly.
- Typing skills of 40 wpm accurately.
- General math skills.