Claims Analyst

Claims Analyst general responsibilities include accurately billing patient accounts, ensuring timely clean claim submission and reimbursement from various third-party payers and patients. Ensuring proper account documentation in the facility's billing system.

• POSITION QUALIFICATIONS

Education and Experience :

High School diploma or GED. Successful completion of data entry, general clerical, ten key and claims analyst standards administered by Cuyuna Regional Medical Center Human Resources staff.

• License / Certificates :

N / A

• Special Skills and Aptitudes :

Ability to work independently

• Ability to perform routine and complex procedures
• Ability to recognize problems, identify the cause and implement solutions
• Effective interpersonal relationship skills including good listening and communication skills
• Ability to handle confidential information discreetly and appropriately
• Ability to adapt resources to meet the needs of the situation
• Adjusts to stressful situations with confidence and good judgment
• ESSENTIAL RESPONSIBILITIES

Receives and interviews incoming patients / residents or representatives to obtain pertinent data

• Confirms insurance benefits, including copies of required documents
• Files or scans documents in an accurate manner
• Responsible, as assigned, to maintain and control a section of billed and unbilled patient accounts
• Responsible, as assigned, to review final bills for accuracy and clean claim submission
• Responsible, as assigned, to review and fix any claim edits or rejections
• Responsible, as assigned to do charge entry for correcting and / or adding charges
• Responsible, as assigned, to void and re-post charges when appropriate
• Responsible, as assigned, to understand and comprehend the billing rules for provider based billing, rural health billing and CAH Method II billing
• Responsible, as assigned, to prepare claims accurately to carriers and intermediaries in a timely manner
• Responsible, as assigned, to follow-up on unpaid and un-process billed claims, and re-bill in a timely manner if necessary
• Demonstrates efficiencies in working with the claims clearing house and any other third party resources needed to get the job done
• Responsible, as assigned, to handle billing questions in a polite and professional manner and log patient complaints
• Handles receipting of payments
• Corrects registration errors and sends for needed billing information
• May be required to work rotating shifts, weekends, and holidays. Ability to meet the scheduling needs of the department
• Demonstrate Standards of Excellence when other duties are assigned.

Lead Responsibilities if applicable :

Direct and check the work of others.

• Participate in the orientation and / or training of employees and provide feedback to management.
• Coordinate the workflow among employees within the work area.
• Provide technical or functional directions and support to employees.
• Inform management on operational needs of the department.
• Assist with the creation of work schedules.
• Approve requests for time off, schedule changes, or additional ours / overtime and determine sick call replacement, according to a jointly pre-approved process, in the absence of a supervisor or manager.
• Excellent Customer Service and communication skills are essential for the lead position.
• Analyze and monitor all assigned work queues, identify error trends and develop training resources to improve accuracy.
• Work closely with all Revenue Cycle staff to identify and create account accuracy improvement projects.
• Serve as a communication liaison between revenue cycle staff for problem accounts and efficiencies.

The pay range for this role is $20.15 to $26.71.

Benefits

Flexible schedule

Competitive wages

Medical, Dental, Vision, & Life insurance options

HSA option

401k contribution

Paid Time Off

Location : Cuyuna Regional Medical Center

• Business Office

Schedule : Full Time, 8-hour Day Shift