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.