REIMBURSEMENT ANALYST- 813052

• Reviews payer EOB’s but not limited to payment accuracy, patient liability, and appeal grievances


• File appeals on underpayments


• Forward appeal letters to scanning


• Generate reports from the Managed Care module to identify issues but not limited to underpayments, total charge adjustments, missing calculations, and contract accuracy


• Generate reports from the Managed Care module to assist management identifying payer problem accounts


• Create a monthly Medicaid HMO underpayment report for the CFO


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


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

• Enter detailed notes explaining account activity in the Patient Accounts system including expected payment calculation

• Identify payer trends for resolution

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

• Assist the Reimbursement Specialist when needed


• Respond to patient inquiries within 2 business days


• Respond to interdepartmental inquiries within 2 business days


• Respond to payer requests within 2 business days


• Respond to emails within 2 business days

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

Education

Required:

    High School

Licenses & Certifications

Preferred:

    C-Heartsaver