Reimbursement Analyst- 813052

College of Charleston • Alamogordo, NM, United States • $200k - $250k / year • 5m ago

Description

• Reviews payer EOBs, focusing on payment accuracy, patient liability, and appeal grievances.

• Files appeals on underpayments.

• Forwards appeal letters to scanning.

• Generates reports from the Managed Care module to identify issues, including underpayments, total charge adjustments, missing calculations, and contract accuracy.

• Generates reports from the Managed Care module to assist management in identifying payer problem accounts.

• Creates a monthly Medicaid HMO underpayment report for the CFO.

• Processes incoming mail correspondence from payers within 3 business days.

• Follows up with the payer via phone and/or the website as needed.

• Enters detailed notes explaining account activity in the Patient Accounts system, including expected payment calculations.

• Identifies payer trends for resolution.

• Reports payer trends to the Director and/or Assistant Director of Patient Financial Services.

• Assists the Reimbursement Specialist when needed.

• Responds to patient inquiries within 2 business days.

• Responds to interdepartmental inquiries within 2 business days.

• Responds to payer requests within 2 business days.

• Responds to emails within 2 business days.

• Maintains courtesy and respect at all times when working with internal and external customers.

Requirements

Education

Required: High School

Licenses & Certifications

Preferred: C-Heartsaver

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