Claims Analyst - Envision Staffing Solutions
Fort Lauderdale, FL
About the Job
Our client in the healthcare space is looking for a Claims Analyst to join their team to help analyze and manage the healthcare claims to ensure accuracy and timely reimbursement. The Claims Analyst will review, process, and resolve claims issued while ensuring compliance with payer guidelines and company policies.
What Your Day-to-Day will look like:
What Your Day-to-Day will look like:
- Identifies and investigates claim denials and rejections.
- Analyzes trends and patterns in claims data to identify potential issues or areas for improvement.
- Develops and implements strategies to resolve issues and reduce the rate of denials. Prepares and submits appeals as necessary.
- Generates reports to support decision-making and optimize the revenue cycle process.
- Works closely with billing, coding, and patient financial services teams to address and resolve claims-related issues.
- Facilitates communication between healthcare providers and payers.
- Ensures compliance with healthcare regulations, payer policies, and company procedures.
- Maintains accurate records of claims processing, including detailed notes on issues, resolutions, and follow-ups.
- Maintains detailed records of collection activities, payment arrangements, and correspondence.
- Monitors and manages assigned accounts, ensuring that all payments and adjustments are accurately recorded and applied.
- Follows up on outstanding patient accounts and insurance claims through phone calls, emails, and written correspondence.
- Performs other duties as assigned.
- Completes special projects as assigned.
- Stay up to date on changes in regulation and payer requirements
- 2-6 Years of Experience in Medical Accounts Receivable, healthcare claims processing, and/or medical billing experience.
- Strong experience in MS Office Suite
- Experience working with claims management software and electronic health records (EHR) systems, such as Epic, NextGen, or similar is a big plus!
Source : Envision Staffing Solutions