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Reimbursement Analyst- 813052

Gerald Champion Regional Medical Center • Alamogordo, NM, United States • $200k - $250k / year • 5m ago

Job Category: Patient Financial Services- Revenue Integrity

Requisition Number: REIMB002937

Posted: September 4, 2024

Employment Type: Full-Time

Locations

Showing 1 location

Responsibilities

Reviews payer EOB’s including 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 calculation
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

Qualifications

Education

Required: High School or better.

Experience

Preferred: 2 years of hospital or physician practice billing and/or collections experience

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