Claims Analyst

🔥 0 minutes ago

🐎 Kentucky – Remote

🐎 Kentucky – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

📋 Claims Specialist

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Lifepoint Health®

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1999

🧬 Biotechnology

💊 Pharmaceuticals

Healthcare • Biotechnology • Pharmaceuticals

Lifepoint Health® is a diversified healthcare delivery network that serves patients, clinicians, communities, and partners across the healthcare continuum. With a presence that extends from coast to coast, Lifepoint operates community hospitals, rehabilitation and behavioral health hospitals, and additional care sites. The company is dedicated to improving community health through high-quality care, patient safety, clinical excellence, and innovative partnerships aimed at enhancing healthcare quality and access.

📋 Description

• 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.

🎯 Requirements

• 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

🏖️ Benefits

• 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.