DESCRIPTION OF POSITION:

• Claims Analyst analyzes and reviews insurance claims for accuracy and completeness to be submitted to the payer. Also maintains open communication with various departments within the facility.

RESPONSIBILITIES AND DUTIES:

• Consistently monitors assignment to ensure that all steps necessary to assist the Team with achieving its goals have been taken.
• Documents all information in the System following the Clear Concise Consistent method.
• Appropriately prioritizes work queue in order to work highest priority first based on assigned subjects.
• Properly utilizes productivity tracking mechanisms.
• Works at or above the weekly set productivity standard and completes tasks in a timely manner.
• Accurately analyzes, corrects and releases assigned claims daily.
• Follows the appropriate process for notification to the responsible area.
• Works with other departments to resolve any outstanding billing deficiencies.
• Consistently analyzes and communicates with leadership and responsible areas on held claims to ensure that all claims are released timely.
• Maintains assigned task by ensuring that the task is completed timely.
• Ability to evaluate a difficult billing problem and find the resolution.

The above statements are only meant to be a representative summary of the major duties and responsibilities performed by incumbents of this job. The incumbents may be requested to perform job-related tasks other than those stated in this description.

EDUCATION AND WORK EXPERIENCE

• High school graduate or GED certificate.
• Prefer at least one year experience in Healthcare or related field.
• Adequate keyboarding and basic computer skills.
• Strong organizational and communication skills.
• Assertiveness with positive attitude and being proactive.

Physical Demands/Work Environment

• Must be able to remain in a stationary position at least 50% of the time.
• Constantly operates a computer and other office machinery such as a calculator, copy machine, fax machine and computer printer.
• Reasonable accommodations may be made to enable individuals with disabilities to perform essential functions.