Claims Analyst

🕒 vor 3 Tagen

🐎 Kentucky – Remote

🐎 Kentucky – Remote

⏰ Vollzeit

🟡 Mittelstufe

🟠 Senior

📋 Schadensspezialist

Jetzt Bewerben

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Lifepoint Health®

WebsiteLinkedInAlle Stellen

1001 - 5000 Mitarbeiter

Gegründet 1999

🧬 Biotechnologie

💊 Pharmazie

Healthcare • Biotechnology • Pharmaceuticals

Lifepoint Health® ist ein diversifiziertes Gesundheitsdienstleistungsunternehmen, das ein landesweites Netzwerk von kommunalen Krankenhäusern, Rehabilitations- und psychiatrischen Krankenhäusern sowie weiteren Versorgungseinrichtungen besitzt und betreibt. Die Organisation arbeitet mit Klinikern, Gemeinschaften und anderen Gesundheitsdienstleistern zusammen, um Akutversorgung, Rehabilitation, psychiatrische Versorgung und ambulante Dienstleistungen bereitzustellen und legt dabei den Fokus auf klinische Qualität, Patientensicherheit, Zugang zur Versorgung und die Auswirkungen auf die Gemeinschaft. Lifepoint operiert als Holdinggesellschaft mit Tochtergesellschaften, die Krankenhäuser und Einrichtungen betreiben, und legt besonderen Wert auf Partnerschaften, Technologie und gemeinschaftsorientierte Programme zur Verbesserung des Gesundheitswertes und der Ergebnisse.

Beschreibung

• Accurately performs billing and collections for multiple facilities for all payors. • Provide professional and technical support to staff across multiple departments. • Respond to inquiries from insurance carriers, patients, and family members regarding billing and account balance questions. • Monitor and review financial systems to ensure accurate revenue recognition and maintain appropriate accounts receivable levels aligned with payer mix and acuity. • Collaborate with Utilization Management departments to ensure pre-certifications, authorizations, and appeals are completed accurately and on time. • Perform effective and timely follow-up on insurance claims to secure appropriate reimbursement. • Analyze explanations of benefits (EOBs), remittances, and explanations of payment (EOPs) to identify discrepancies or underpayments. • Research and resolve claim issues • Prepare, submit, and track appeals for denied claims through resolution. • Prepare for and actively participate in weekly Accounts Receivable (AR) meetings.

🎯 Anforderungen

• High school diploma required; Associate degree preferred with 3–5 years of computerized medical billing experience required with behavioral healthcare experience preferred and working knowledge of Medicare/Medicaid and institutional billing requirements. • Strong knowledge of Medicare/Medicaid guidelines and UB04 billing requirements • Proficiency in computerized medical billing systems • Ability to manage multiple facilities and payor types simultaneously • Strong analytical and problem-solving skills • Effective communication with internal teams and external stakeholders • Detail-oriented with strong organizational skills • Ability to work in a fast-paced, high-volume, production-based environment • Understanding of Hospital Revenue Cycle processes within a multi-facility healthcare environment

🏖️ Vorteile

• Comprehensive Benefits: Multiple levels of medical, dental and vision coverage for full-time and part-time employees. • Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off. • Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match. • Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs). • Professional Development: Ongoing learning and career advancement opportunities.