Insurance Claims Analyst (Full-time, Monday - Friday, 8:00am-4:30pm)

WASHINGTON REGIONAL MEDICAL CENTER • Fayetteville, AR

2d • Onsite

About The Position

The role of the Insurance Claims Analyst reports to the assigned Insurance Billing Manager. This position reviews, processes, and analyzes medical insurance claims for accuracy and compliance with policies, investigating discrepancies and ensuring timely payments to providers. This position is responsible for verifying patient information, checking for coding errors (like ICD-10 and CPT), effectively and efficiently communicating with healthcare providers and internal departments, and maintaining detailed records. This position requires strong analytical and problem-solving skills, a keen eye for detail, and familiarity with medical billing and claims management software.

Requirements

• High School graduate or GED
• Basic working knowledge of the MS Office suite of software, and the ability to operate standard office equipment.

Nice To Haves

• Previous billing and claims experience within a hospital and/or clinic business office with 2+ year experience, preferred.
• Broad knowledge of medical terminology, medical collections, MS-DRG coding methodology, ICD-10 and CPT coding, preferred.

Responsibilities

• Analyze insurance claims to ensure accuracy, completeness, and compliance with policy guidelines.
• Verify patient information and check for errors in billing and coding.
• Investigate and resolve discrepancies, such as claim denials or billing issues, by communicating with providers and internal departments.
• Provide timely and efficient follow-up on all outstanding AR using assigned ATB worklist reports, using various systems, including Payor portals, Payor phone inquiries and/or written communications
• Ensure claims are processed efficiently and that reimbursements are paid correctly and on time.
• Apply knowledge of healthcare industry policies, regulations, and medical billing codes (like ICD-10 and CPT) to ensure correct billing practices.
• Maintain detailed records of claims and prepare reports on claims data, trends, and financial performance
• Maintain AR collection of claims at less than 30 days of account age
• Serve as a liaison with healthcare providers, patients, and internal departments to answer questions and resolve issues.

What This Job Offers

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