Advanced Reimbursement Analyst - Healthcare Claims A/R

Guidehouse • Lewisville, TX

1d • Hybrid

About The Position

The Advanced Reimbursement Analyst will identify, document and collect managed care, Medicare/Medicaid underpayments for Contract and Reimbursement Solutions Clients. Perform any and all related job duties as assigned. This position will be on a hybrid schedule working two days either in the Lewisville, TX office or El Segundo, CA office and three days from home.

Requirements

• High School Diploma / GED or 3 years of Relevant Equivalent Experience in Lieu of Diploma / GED.
• 1-3+ year's experience in office, business, operations, customer service or healthcare field.

Nice To Haves

• Experience working with Medicare/Medicaid claims as well as Commercial Payors
• Experience in healthcare billing/collections or claims processing in a hospital environment
• Experience with hospital systems such as Cerner, Epic or Meditech preferred
• Persuasive negotiator.

Responsibilities

• Collect on identified underpayments.
• Document any activity that affects account.
• Reconcile accounts based on contract terms.
• Work w/contract dept. on any pricing issues.
• Review Medicare/Medicaid and managed care payments to verify consistency with payment terms of corresponding contract between client and payor.
• Keep current on Medicare/Medicaid payment changes.
• Maintain accurate, timely and thorough documentation regarding underpayments.
• Bill payors for additional payment.
• Perform timely and effective collection efforts.
• Maintain departmental databases.
• Produce periodic status reports.
• Assist departmental staff with assigned tasks.
• Maintain confidentiality of company, client and patient information.
• Maintain confidentiality of all private health information and contract terms.
• Perform all activities within the limitations of applicable laws and regulations.
• Maximize collection of patient accounts.
• Perform all responsibilities in a professional manner and consistent with the instructions provided by the client.

Benefits

• Medical, Rx, Dental & Vision Insurance
• Personal and Family Sick Time & Company Paid Holidays
• Parental Leave
• 401(k) Retirement Plan
• Basic Life & Supplemental Life
• Health Savings Account, Dental/Vision & Dependent Care Flexible Spending Accounts
• Short-Term & Long-Term Disability
• Tuition Reimbursement, Personal Development & Learning Opportunities
• Skills Development & Certifications
• Employee Referral Program
• Corporate Sponsored Events & Community Outreach
• Emergency Back-Up Childcare Program

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED