Medical Claims Analyst (Remote)

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Lakeshore Talent is partnered with a local healthcare network in search of a Remote Claims Analyst to support a hospital in Broomfield, CO. This is a fully remote position, but the Claims Analyst must reside in Colorado. 

Pay: $18 – $22 per hour (depending on experience)
Shift: Monday – Friday 8:00 am – 4:30 pm (fully remote)

Duties:

• Demonstrate an understanding of complete revenue cycle from patient charge entry to applying payment.
• Resolves both undistributed and credit balance accounts while working from an assigned work list.
• Researches all aspects of the claim cycle to identify and correct errors which cause misappropriated funds. Documents all actions taken on the electronic patient account.     
• Verifies payer remittance to apply payments appropriately. Utilizes resources to find payment documentation. Interprets payer contracts to ensure all codes on patient’s account matches our contracts. Reviews EOB to make sure payments were applied correctly, insurance processes correctly, and the posting is correct. Understand how to evaluate over payments.         
• Performs GAP analysis. Processes adjustments and recoups.
• Manages assigned work queue for patient accounts. Identifies, researches and proposes solutions to trends.

Qualifications:

• High School Diploma or Equivalent is required.
• One year of medical revenue cycle experience or cash handling in a business environment, including resolving invoicing issues is required.
• Three years of Hospital/physician billing or claims follow-up and previous Insurance denials, appeals and payment posting experience is preferred.
• Knowledge of general medical billing, insurance, and compliance regulations and coding.
• Knowledge of medical terminology.

JOB ID: 47955

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