Claims Analyst

This is a fully remote position, open to applicants in Kentucky.

📋 Description

• Efficiently manages billing and collections for various facilities across all payors.

• Provide expert technical support to personnel in multiple departments.

• Address inquiries from insurance providers, patients, and family members concerning billing and account balance matters.

• Oversee and assess financial systems to guarantee precise revenue recognition and maintain suitable accounts receivable levels in accordance with payer mix and acuity.

• Work collaboratively with Utilization Management departments to ensure pre-certifications, authorizations, and appeals are accurately completed and timely submitted.

• Conduct prompt and effective follow-up on insurance claims to secure proper reimbursement.

• Evaluate explanations of benefits (EOBs), remittances, and explanations of payment (EOPs) to identify any discrepancies or underpayments.

• Investigate and resolve claim-related issues.

• Prepare, submit, and monitor appeals for denied claims until resolution.

• Get ready for and actively engage in weekly Accounts Receivable (AR) meetings.

⛳️ Requirements

• High school diploma is mandatory; an Associate degree is preferred.

• 3–5 years of experience in computerized medical billing is required; experience in behavioral healthcare is preferred.

• Strong understanding of Medicare/Medicaid guidelines and UB04 billing requirements.

• Proficient in computerized medical billing systems.

• Capable of managing multiple facilities and payor types concurrently.

• Excellent analytical and problem-solving abilities.

• Effective communication skills with both internal teams and external stakeholders.

• Detail-oriented with exceptional organizational skills.

• Ability to thrive in a fast-paced, high-volume, production-oriented environment.

• Familiarity with Hospital Revenue Cycle processes in a multi-facility healthcare setting.

🏝️ Benefits

• Comprehensive Benefits: Multiple tiers of medical, dental, and vision coverage available for both 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: Tuition assistance for higher education and certification, loan assistance, and a 401(k) retirement plan with company matching.

• Employee Well-being: Programs focused on mental, physical, and financial wellness (including free gym memberships, virtual care appointments, mental health services, and discount programs).

• Professional Development: Continuous learning and career advancement opportunities.