Reimbursement Analyst- Collection Lead

Lake Charles Memorial Hospital • Lake Charles, LA

4h • Onsite

About The Position

The Reimbursement Analyst is responsible for evaluating all aspects of the claims escalation team to maximize processes, evaluating and overturning denials to provide denial trend information to leadership, and providing team management. This role reports directly to the Collection Supervisor.

Requirements

• High school graduate or GED certificate, required.
• Adequate keyboarding skills (40 words per minute typing rate).
• Basic computer skills.
• Strong organizational and communication skills, including ability to discuss medical issues.
• Negotiation skills including assertiveness and being proactive.

Nice To Haves

• Two to Four year degree or least four-year experience in Healthcare or related field preferred.

Responsibilities

• Oversee daily collection process; provide employee training and development evaluations, report daily employee progress/performance.
• Compose, distribute, and analyze collection productivity reports daily and assign tasks to maximize the quality of productivity.
• Create procedures that effectively demonstrate proper collection techniques and train all team members to be in compliance.
• Evaluate and interpret Payor contracts to identify error payments, underpayments, and maximize insurance reimbursement.
• Maintain updated information regarding changes to Insurance Carrier policies and communicate to leadership, departments, and collection team.
• Effectively evaluate aged denials to determine balance adjustments and/or if additional escalation is needed.
• Reviews weekly payment reports to satisfy accounts, resolve discrepancies, and/or track trends.
• Communicate with outside vendors, repricing companies and negotiation service suppliers to facilitate correct claim payments.
• Negotiate Single Case Agreements (SCA) or Out of Network Agreements (ONA) to ensure acceptable and timely reimbursements on accounts.
• Effectively evaluate AR to identify problematic processing trends and communicates finding to various Departments and Managers for resolution.
• Utilizes system resources in order to compile reports and provide accurate feedback regarding Denials and Underpayments to Administration.
• Accurately evaluates each account in order to determine what is needed, what is left outstanding, and what steps are necessary to resolve the account quickly.
• Properly utilizes productivity tracking mechanisms.
• Works at or above the weekly set productivity standard and completes tasks in a timely manner.
• Appropriately prioritizes work queue in order to work highest priority first based on assigned subjects.
• Documents all information in the System following the Clear Concise Consistent method.
• Consistently monitors assignment to ensure that all steps necessary to assist the Team with achieving its goals have been taken.
• Writes clearly and informatively. Edits work for spelling and grammar. Varies writing style to meet needs.

Benefits

• Opportunity to be a part of an organizational culture that supports not only exceptional patient care but also the well-being and professional growth of our employees.
• Contributions are valued, growth is nurtured, and success is celebrated.

What This Job Offers

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