Payment Review Analyst
About The Position
Under the supervision of the PFS Director, the Payment Review Specialist position is responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate regulations in order to assure compliance in payment practices.
Requirements
- Minimum three years hospital billing and collection experience
- Medical and Insurance terminology essential
- Knowledge of CPT, ICD-9, HCPCS coding structures
Responsibilities
- Accurate and timely payment analysis of managed care contracts
- Analyze payments received from insurance companies to assure maximum and correct reimbursement receivables
- Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment
- Utilizes and applies the appropriate regulations in order to assure compliance in payment practices
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What This Job Offers
Job Type
Full-time
Education Level
No Education Listed
