Advanced Reimbursement Analyst - Healthcare Claims A/R

Guidehouse•Lewisville, TX

3d•Hybrid

About The Position

The Advanced Reimbursement Analyst identifies, documents, and collects managed care and Medicare/Medicaid underpayments for Contract and Reimbursement Solutions clients. The role reviews payments against contract terms, pursues additional payments from payors, reconciles accounts, maintains records and databases, and prepares status reports. The position follows a hybrid schedule, working two days at either the Lewisville, Texas, or El Segundo, California, office and three days from home. The analyst may perform other related duties as assigned and must protect confidential company, client, patient, and health information while conducting work in accordance with applicable laws and client instructions.

Requirements

High school diploma or GED, or three years of relevant equivalent experience in lieu of a diploma or GED.
At least 1 year of experience in an office, business, operations, customer service, or healthcare field; the posting states 1–3+ years.

Nice To Haves

Experience working with Medicare/Medicaid claims and commercial payors.
Experience in healthcare billing/collections or claims processing in a hospital environment.
Experience with hospital systems such as Cerner, Epic, or Meditech.
Persuasive negotiation skills.

Responsibilities

Collect identified underpayments.
Document account activity accurately, thoroughly, and promptly.
Reconcile accounts based on contract terms.
Work with the contract department to resolve pricing issues.
Review Medicare/Medicaid and managed care payments for consistency with the payment terms of the relevant client-payor contract.
Keep current on Medicare/Medicaid payment changes.
Bill payors for additional payments.
Conduct timely and effective collection efforts to maximize collection of patient accounts.
Maintain departmental databases and produce periodic status reports.
Assist departmental staff with assigned tasks.
Maintain confidentiality of company, client, patient, and private health information, as well as contract terms.
Perform activities within applicable legal and regulatory limits and carry out responsibilities professionally and consistently with client instructions.

Benefits

Medical, prescription, dental, and vision insurance.
Personal and family sick time and company-paid holidays.
The position may be eligible for a discretionary variable incentive bonus.
Parental leave.
401(k) retirement plan.
Basic and supplemental life insurance.
Health Savings Account and dental/vision and dependent-care Flexible Spending Accounts.
Short-term and long-term disability.
Tuition reimbursement, personal development, and learning opportunities.
Skills development and certifications.
Employee referral program.
Corporate-sponsored events and community outreach.
Emergency back-up childcare program.