Analyst-Insurance Coverage Quality

Baptist • Memphis, TN

1d

About The Position

The Insurance Coverage Quality Analyst is responsible for ensuring accurate and timely insurance coverage updates across patient accounts. This role focuses on improving coverage validation, reducing self-pay balances, and minimizing billing errors through proactive account reviews, customer service engagement, and workflow optimization.

Requirements

• Minimum 2 years in insurance verification, billing, or revenue cycle operations.
• Familiarity with Hospital and Physician Billing workflows.
• Strong attention to detail and analytical skills.
• Excellent communication and customer service abilities.
• Proficiency in healthcare billing systems and work queue management.

Nice To Haves

• Associate’s or Bachelor’s degree in Healthcare Administration, Business, or related field

Responsibilities

• Add and correct insurance coverage on patient accounts.
• Perform retro authorizations and rebill accounts as needed.
• Validate coverage for discharged patients.
• Conduct daily, future, and post-discharge self-pay scrubs (30, 60, and 90-day).
• Review eligibility denials for potential coverage by other payers and DSH eligibility.
• Manage Out-of-Network (OON) work queues and ensure all commercial insurances are added for OON accounts.
• Monitor and resolve failed billing account work queue errors related to coverage effective dates and validation checks.
• Provide staff education on coverage processes and best practices.
• Work closely with facility teams on First Source identified coverage and in-house insurance changes.
• Completes additional assignments as needed.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: Associate degree