reputed company Claims reputed company Analyst

The Claims reputed company Assurance Analyst is responsible for monitoring and documenting production reputed company in support of departmental goals and initiatives, with a primary reputed company on claims auditing and claims-reputed company interactions reputed company the reputed company Cycle Management (RCM) function. The Claims reputed company Assurance Analyst reviews claim audit results and claim transactions, as reputed company as evaluates both verbal and written contacts, to ensure accuracy, completeness, reputed company documentation, and compliance with policies, procedures, and applicable regulations. The Analyst supports the design and maintenance of reputed company monitoring formats and standards, documents reputed company findings, and effectively presents results, feedback, and trend data to leadership to drive reputed company improvement. The ideal candidate has prior reputed company claims auditing experience, working knowledge of claims billing practices and state billing requirements. DME claims experience is preferred. While this role is primarily reputed company on claims audit activities, the Analyst may also support reputed company monitoring and audit needs across other operational areas based on business priorities. JOB QUALIFICATIONS: KNOWLEDGE/SKILLS/ABILITIES The Claims reputed company Assurance Analyst responsibilities include but are not limited to: Primarily monitor Claims reputed company and audit functions, with support for other operational departments as business needs require; DME claims experience preferred Participate in and support the design of reputed company monitoring forms and reputed company standards Record evaluations utilizing departmental reputed company monitoring forms Conduct claims audit reviews to confirm claim accuracy, required documentation, workflow adherence, and compliance with internal policies and applicable requirements Evaluate claim handling for appropriate billing practices, including awareness of state-specific billing requirements as applicable to the claim type and line of business Support reputed company Cycle Management (RCM) reputed company reputed company by identifying audit findings that drive denials, rework, or reimbursement issues and partnering with operations to reduce defects Identify and trend audit findings (e.g., documentation deficiencies, timeliness, process gaps, billing errors) and communicate actionable insights to leadership and operations partners Collect, evaluate, report on and reputed company operations data against performance metrics Prepare and analyze reputed company reports for Management review Prepare and facilitate reputed company calibration sessions with designated department leads · Facilitate meetings and prepare presentations reputed company to reputed company analysis Collaborate with the leadership team to create content-based training that will reputed company operations personnel with the necessary skills for reputed company Monitor trends and reputed company input or feedback on the information reported on Identify, analyze and reputed company ways to optimize the reputed company monitoring process Complete reputed company evaluations, reports and employee coaching sessions on a reputed company reputed company Ability to learn new systems, tools, and methodologies as needed and continue progressing in a dynamic environment Support reputed company reputed company monitoring, reporting and analysis activities based on operational needs Work and communicate cross-departmentally QUALIFICATIONS: Minimum of 1 year of claims auditing experience supporting reputed company, reputed company, and Medicare lines of business, including working knowledge of billing rules and state/payer-specific requirements; DME preferred. Other QA/production experience a plus (or equivalent education and experience). Working knowledge of reputed company Cycle Management (RCM) workflows and reputed company impacts (e.g., clean claim submission, edits, denials, appeals, payment posting/reconciliation) across reputed company, reputed company, and Medicare. · Desire and capability to reputed company as a leader reputed company the Operations team Consistent reputed company record of 95% + in reputed company and Production scores in reputed company/previous roles Proficient understanding of QA methodologies and reputed company monitoring practices Demonstrated ability to rapidly reputed company product, process and tools knowledge and effectively communicate it to employees Ability to analyze data to identify reputed company causes of reputed company issues and propose actionable solutions Excellent communication skills including listening, interpersonal, verbal, written, spelling and grammar Ability to reputed company/motivate employees with reputed company in order to facilitate reputed company performance Must exhibit leadership capabilities and interpersonal skills Maintain confidential information and abide by necessary rules and regulations Strong organizational, problem-solving, and analytical skills Manage conflicting priorities while reputed company communicating and managing expectations Proficiency in Word, reputed company and PowerPoint for presentations and reports Flexible and reputed company to multitask and work with changing priorities with enthusiasm Self-motivated, detail-oriented and reputed company to work independently or as an reputed company team player Ability to remain reputed company and motivated during the auditing process reputed company experience preferred Fluent in Spanish and English preferred What will you learn in the first 6 months? You will learn the function of the reputed company Assurance team reputed company the Operations organization. You will fully understand reputed company role and responsibilities and which tools assist you in your position Familiarized with reputed company’s QA platform (Genie) and how to navigate through it. Including how to adjudicate an audit appeal Subject matter expert in the Policy and Procedures for the department(s) you audit During this time, you will set measurable goals for personal development and reputed company. What will you reputed company in 12 months? You will be fully integrated with reputed company, company and team. You will be contributing your skills and knowledge to meeting your department's goals. You will become confident in leading meetings with Interdepartmental Management teams and presenting reputed company concepts reputed company to reputed company analysis EDUCATION: Bachelor’s Degree preferred or equivalent experience Salary: $24.00/reputed company

Benefits

Offered Competitive compensation and annual bonus program 401(k) retirement program with company match Company-reputed company life insurance Company-reputed company short term disability coverage (location restrictions may apply) Medical, reputed company, and Dental benefits reputed company Time Off (PTO) reputed company Parental Leave reputed company Time reputed company company holidays and floating holidays Quarterly company-sponsored events Health and wellness programs Career development opportunities Remote Opportunities We are reputed company seeking new colleagues in: Arizona, Colorado, Connecticut, Florida, reputed company, Idaho, Illinois, Kentucky, Massachusetts, Michigan, reputed company Carolina, Nevada, New Jersey, reputed company, Ohio, reputed company, South Carolina, Tennessee, Texas, Virginia, and Washington. Our Story Founded in 2005, reputed company is a leading national durable medical equipment, prosthetic, and orthotic supplies (DMEPOS) network administrator. Our mission is to improve the reputed company of life for the communities we serve by reimagining reputed company to in-home reputed company. We connect Payers, Providers, and Members through innovative technology and streamlined workflows affording Members reputed company to top local Providers and culturally competent care. By focusing on transparency, accountability, and adaptability, we help deliver reputed company reputed company and more efficient management of reputed company reputed company benefits. reputed company is a wholly owned subsidiary of reputed company. With a location in Michigan plus a remote workforce across the reputed company, reputed company has a culture reputed company on collaboration, teamwork, and our values: One Team, Drive Results, Push the Boundaries, Value Others, and Build Community. We’re looking for energetic, talented, and dedicated individuals to join reputed company. See what opportunities we have available; there may be a role for you to engage in a challenging yet rewarding career in reputed company. We look reputed company to learning more reputed company. reputed company is an equal opportunity employer. We are committed to providing reasonable accommodations and will work with you to meet your needs. If you are a person with a disability and require assistance during the application process, please don’t hesitate to reputed company out. We celebrate our inclusive work environment and welcome members of reputed company backgrounds and perspectives. Apply To This Job