Medical Insurance Billing & Reimbursement Analyst I
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About The Position
The Medical Insurance Billing & Reimbursement Analyst I at Keystone Laboratory, Inc. is a pivotal role that focuses on maximizing reimbursements through effective communication with insurance carriers and third parties. This position is situated in Asheville, NC, a region known for its stunning natural beauty and vibrant community. The analyst will be responsible for daily interactions to collect outstanding insurance balances, resolve disputes, and address denials and non-payment issues. Additionally, the role involves managing patient balances, negotiating, and recovering outstanding amounts, ensuring that the financial aspects of patient care are handled efficiently and effectively. In this role, the analyst will need to possess a comprehensive understanding of payer determinations, contract fees, and the various elements that affect billing, such as diagnosis codes, modifiers, and eligibility requirements. The analyst will monitor payer policy changes and ensure compliance with all relevant laws and regulations, as well as internal policies. The position requires the preparation, review, and transmission of claims using billing software, ensuring that claims are submitted accurately and within the required timeframes. The analyst will also be tasked with resolving clearinghouse rejections, reconciling outstanding balances, and sending appeals when necessary. A critical part of the job is to maintain accurate records of billing and collection activities, ensuring that all patient information is handled confidentially in accordance with HIPAA regulations. The analyst will engage in proactive problem-solving to address claim issues and will communicate effectively with physician offices and patients to secure necessary documentation for payment. Overall, this role is essential in supporting the financial health of the organization while providing excellent service to patients and insurance carriers alike.
