Claims Analyst

• POSITION SUMMARY
  • 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
  • 1. Receives and interviews incoming patients/residents or representatives to obtain pertinent data
    2. Confirms insurance benefits, including copies of required documents
    3. Files or scans documents in an accurate manner
    4. Responsible, as assigned, to maintain and control a section of billed and unbilled patient accounts
    5. Responsible, as assigned, to review final bills for accuracy and clean claim submission
    6. Responsible, as assigned, to review and fix any claim edits or rejections
    7. Responsible, as assigned to do charge entry for correcting and/or adding charges
    8. Responsible, as assigned, to void and re-post charges when appropriate
    9. Responsible, as assigned, to understand and comprehend the billing rules for provider based billing, rural health billing and CAH Method II billing
    10. Responsible, as assigned, to prepare claims accurately to carriers and intermediaries in a timely manner
    11. Responsible, as assigned, to follow-up on unpaid and un-process billed claims, and re-bill in a timely manner if necessary
    12. Demonstrates efficiencies in working with the claims clearing house and any other third party resources needed to get the job done
    13. Responsible, as assigned, to handle billing questions in a polite and professional manner and log patient complaints
    14. Handles receipting of payments
    15. Corrects registration errors and sends for needed billing information
    16. May be required to work rotating shifts, weekends, and holidays. Ability to meet the scheduling needs of the department
    17. 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

Salary : $20 - $27