Third Party Analyst

Care New England Health System•Warwick, RI

56d

About The Position

Reporting to the Supervisor of A/R Management, the Third Party Analyst proactively manages and analyzes Care New England’s accounts receivable. By staying on top of current and past-due balances (including secondary accounts) and resolving denied or unpaid claims, the Analyst ensures accurate, timely reimbursement. This role collaborates closely with patients, providers, insurance carriers, and various stakeholders to streamline billing processes. Additionally, the Third Party Analyst supports the supervisor with reporting, trends analysis, and acts as a key liaison for all billing-related issues.

Requirements

High school diploma required.
Minimum of two years of related experience in a healthcare environment or accounts receivable required
Excellent interpersonal and communication skills.
Strong typing skills and attention to detail.
Ability to make appropriate decisions/judgment calls regarding accounts receivable.
Solid understanding of insurance and governmental billing guidelines.
Proficiency in documenting account activity and maintaining accurate records.

Responsibilities

Track and maintain accounts receivable by aging categories.
Review third-party credits to determine if adjustments, refunds, or recoups are needed.
Communicate with insurance carriers, patients, and staff to resolve claim reimbursements.
Manage secondary balances and denied/unpaid claims past contractual deadlines.
Apply established policies and procedures for charity care, discounts, and adjustments.
Accurately record account history and actions in systems within specified timeframes.
Notify supervisor of denial trends or other A/R issues.
Prepare reports and provide insight into accounts receivable trends.
Follow insurance, state, and federal regulations, as well as internal policies.
Safeguard patient confidentiality under HIPAA standards.
Promptly handle phone calls, emails, and mail from insurance carriers and patients.
Deliver excellent customer service when interacting with patients, providers, and insurers.
Maintain positive relationships with internal and external stakeholders.
Prioritize tasks to meet deadlines.
Identify and recommend improvements to billing, workflow, or claims processes.
Maintain familiarity with hospital contracts and payment policies to ensure consistent reimbursement.
Collaborate with peers and management to achieve departmental objectives.
Contribute ideas and feedback during team meetings.
Assist coworkers as needed to optimize performance.
Engage in relevant training, workshops, and professional development.
Stay current on healthcare billing regulations and payer guidelines.
Maintain punctual attendance and professional conduct.
Adhere to dress code and appearance guidelines.
Perform other duties as assigned by leadership.