[Remote] reputed company Claims reputed company Analyst
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is a leading national durable medical equipment network administrator. The Claims reputed company Assurance Analyst is responsible for monitoring and documenting production reputed company, focusing on claims auditing and interactions reputed company the reputed company Cycle Management function, while also supporting reputed company monitoring across operational areas as needed.
Responsibilities
- 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
Skills
- 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
- DME claims experience
- reputed company experience preferred
- Fluent in Spanish and English preferred
- Bachelor's Degree preferred or equivalent experience
Benefits
- 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
reputed company