Insurance Analyst I

Eisenhower Health•Rancho Mirage, CA

8d•$19 - $29

About The Position

The Insurance Analyst I performs account review, follow-up, and collections, including double recoupment, correspondence, and credit balance resolution. The role works in Patient Financial Services and manages claims and accounts to promote timely payment and resolution, while following organizational compliance policies and payer requirements.

Requirements

High school diploma, GED, or higher degree.
One year of billing or collections experience, billing certification, or a prior successful internship or temporary assignment in a patient financial service setting.
Ability to handle multiple projects or tasks simultaneously and prioritize workload.
Ability to interpret payer contracts and federal and state regulatory guidelines.
Ability to operate basic office equipment, including copiers, fax machines, and calculators.
Ability to prioritize tasks and manage time efficiently to meet deadlines.
Knowledge of computer-based claims management.
Knowledge of database systems and internet applications.
Knowledge of medical terminology.
Strong customer service and problem-solving skills.
Strong Windows knowledge and keyboarding skills.

Nice To Haves

Experience with managed care and Medicare/Medi-Cal billing regulations.

Responsibilities

Demonstrate compliance with the Code of Conduct and compliance policies, resolve compliance questions or concerns, and report suspected violations.
Manage new accounts daily in the Receivables Workstation; coordinate with hospital departments to obtain information needed to process or resolve claims, and contact patients or account guarantors to solicit payment.
Work all accounts in the Follow-Up queue daily to promote collections, including contacting payers by telephone or through payer messaging and websites.
Manage account inventory promptly to promote payment and resolution as instructed by management.
Stay current on payer requirements by reviewing bulletins, provider handbooks, websites, and other resources.
Process incoming correspondence, including signature letters, denials, prior authorizations, and information needed to process claims.
Record newly identified insurance plans and facilitate their account processing in accordance with pre-billing policies and procedures.
Record accurate, definitive notes in electronic account files describing account status, issues, and anticipated resolution dates.
Escalate account-management issues to leadership when needed.
Keep leadership informed of contract, payer, or system changes and issues.
Assign a status code to each worked account to support tracking, statistical reporting, and audits.
Manage new credit balance accounts daily and prepare adjustments or refunds to bring balances to zero.
Handle special projects assigned by leadership, such as high-dollar accounts or accounts over 180 days old.
Attend in-house training and classes on federal and state billing regulations and compliance issues and guidelines as requested.
Maintain productivity standards by payer assignment.
Perform other duties as assigned.