Insurance Analyst, Business Office, Nashville

Heritage Medical Associates•Nashville, TN

3h•Onsite

About The Position

Insurance Analysts demonstrate thorough knowledge of the claims revenue cycle. The Insurance Analyst position is responsible for answering patient and staff inquiries, reviewing outstanding and/or denied insurance claims, submitting insurance appeals, and maintaining assigned insurance queues. Insurance Analyst must have the ability to provide excellent Customer Service to patients and staff and correctly answer a question regarding insurance and balances. The type of questions may include, but are not limited to insurance participation, correct coding guidelines, carrier specific medical policies, and denial codes, review of accounts for payment application, as well as the ability to assist patient and/or staff in understanding insurance benefits and how the benefits were applied to the service(s) received at HMA.

Requirements

Strong Customer Service Skills
Excellent telephone etiquette and skills
Exceptional written and verbal communication skills
Ability to work with little supervision
Superior organizational skills
Self motivated
Ability to work in a cooperative manner with others
Regular and predictable attendance
High school diploma
3-5 years of third-party billing in a physicians office
Knowledge of ICD-10/CPT Coding
Experience in medical billing systems
Must have thorough understanding of Medicare/Medicaid laws, managed care, and commercial health insurance
Must be able to walk to patient in physicians office and/or sit for 8 to 10 hours a day
Requires regular walking, bending, pushing, pulling, twisting and lifting
Must be able to lift at least 10-15lbs
Ability to delineate between numeric numbers

Responsibilities

Work denied claims through the practice management queue
Processing of denials in a timely and accurate manner
Correct and any denied claim, including submitting additional information or documentation as requested
Creation and submission of appeals
Communicate with insurance companies, as needed
Query provider in a timely manner, as needed
Interpret and apply compliance guidelines to maintain billing integrity
Update and maintain patient account information and have the ability to make adjustments as necessary, and according to company policy
Receive, sort and work incoming correspondence daily
Identify and communicate trends in denials to management
Answer patient questions, inquiries and concerns regarding their accounts; verify balances and refunds for accuracy, and ensure timely follow up with patient, as needed.
Audit accounts referred by Patient Service Representatives and Patient Accounts, as well as provide a response in a timely manner
Utilize the Insurance Analyst work queues to follow up on accounts until the account has been satisfactorily resolved.
Post corrected claims and any payments associated with that correction
Transfer credits in an account
Follow HMA guidelines in applying self-pay discounts, charity and per request adjustments.