Claims Analyst

Job description:

• Analyzing, researching, and preparing insurance claims for submission to insurance carriers (commercial and government)
• Responding to inquiries, billing denials and other communications
• Meet production requirements by working accounts according to management’s specifications
• Attach necessary documentation when mailing claims to payors (i.e. EOBs, Medical Records, itemized statements, etc.)
• Make Telephone inquiries, according to policy, on delinquent claims. Involves the patient as allowable under contract.
• Status account and document all work performed in the company and client computer systems.
• Reconcile balances and payments between insurance companies and client’s computer systems.
• Provide excellent customer service
• Perform additional duties as assigned

Qualifications:

• Knowledge of medical and insurance terminology (such as procedure codes, diagnoses, and patient liability) and full understanding of hospital/physician billing
• Direct experience with Hospital and Physicians Insurance companies claims follow up highly preferred
• Ability to read and understand EOB statements
• Understanding of co-pay, co-insurance, primary and secondary payor in regard to medical insurance coverage, paper and electronic claims processing
• Minimum 1-2 years’ experience in Medical Billing/Follow-up for a facility, medical clinic or doctor’s office and experience with Microsoft Office suite and standard office equipment required.
• Knowledge and understanding of HIPAA and compliance
• High school diploma or equivalent preferred