EOB/Payment Review Analyst
About The Position
The Payment Review Specialist is responsible for accurately and promptly analyzing managed care contract payments to determine whether appropriate reimbursement has been received. The role uses complex and varying regulations, guidelines, and systems to analyze insurance company payments and ensure maximum and correct reimbursement of hospital receivables. The analyst proactively works with payers and internal resources to identify and resolve issues that interfere with optimal and correct account payment, applying relevant state and federal regulations to ensure compliance in payment practices. The position operates under the supervision of the Director.
Requirements
- At least three years of hospital billing and collection experience.
- Medical and insurance terminology knowledge.
- Knowledge of CPT, ICD-9, and HCPCS coding structures.
Responsibilities
- Analyze managed care contract payments accurately and promptly to determine whether appropriate reimbursement has been received.
- Analyze insurance company payments using applicable regulations, guidelines, and systems to ensure maximum and correct reimbursement of hospital receivables.
- Work proactively with payers and internal resources to identify and resolve issues that hinder optimal and correct account payment.
- Apply appropriate state and federal regulations to ensure compliance in payment practices.
Benefits
- Paid time off
- 401K retirement plan
- Medical coverage
- Dental coverage
- Vision coverage
- Tuition reimbursement
- Voluntary benefit options
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
Education Level
No Education Listed
