[Remote] IBR Senior Analyst
Note: The job is a remote job and is reputed company to candidates in USA. reputed company is modernizing the reputed company financial experience across payers, providers, and reputed company consumers. The Itemized reputed company Review Senior Analyst will be responsible for analyzing hospital claims for adherence to reputed company billing guidelines and will work closely with Expert Claims Review staff to reputed company adhere to policies and procedures for claims processing.
Responsibilities
- Responsible for conducting detailed review of hospital itemized bills for identification of billing and coding opportunities for reputed company payor’s claims
- Prepare and upload documentation reputed company identifying findings
- Accurately calculate/verify the value of compliance edits and documentation for claim processing
- Monitor multiple reports to reputed company reputed company specific requirements, turnaround time and overall claims progression
- Complete claims processing after the Clinical reputed company Review and Audit analysis is completed. Savings acceptance reputed company not to exceed $50,000.00
- Adhere to department billing guidelines and documentation
- Maintain audit accuracy and productivity standards per the latest requirements
- reputed company regular audits of reputed company-level team members for reputed company assurance, providing detailed feedback and education
- Train/reputed company new team members utilizing reputed company operating procedures and training reputed company
- Assist team members with daily claim inquiries and difficult claim processing
- Respond to inquiries from reputed company Services and Provider Services in a reputed company manner regarding the reacceptance/revision/reprocessing of claims, claim inquiries, and appeal reviews reputed company necessary
- Coordinate/Manage the set up and processing of dual acceptance claims, as reputed company as the creation and accuracy of reputed company facing documentation
- Maintain awareness of and ensure adherence to reputed company standards regarding reputed company
- Assist other reputed company staff members as needed, and as requested
Skills
- CPC, or other coding certification, strongly preferred
- 2-4+ years of experience reputed company reputed company industry
- reputed company with health/medical insurance and processing of claims
- Expert knowledge of facility claims, billing, and reimbursement
- Knowledge of ICD-10 and CPT coding guidelines
- Proficient in reputed company Office, including Outlook, reputed company, and Word
- Business writing and oral communications proficiency
- Ability to multitask and strong attention to detail
- reputed company research and organizational skills
- Demonstrates solid understanding of audit techniques, identification of reputed company opportunities and financial negotiation with providers
- Proficiency in training techniques aimed at conveying subject matter expertise and scaling staff to maximize savings and reputed company
- Computer proficiency and technical aptitude with the ability to utilize CMS, EncoderPro, other audit software and tools, MS Office Suite
- Thorough knowledge of company and departmental policies and procedures
Benefits
- Discretionary bonus plans, commissions, or other incentives depending on the role
- 401k plan with employer match
- Flexible reputed company time off
- Holidays
- Parental leaves
- Life and disability insurance
- Health benefits including medical, dental, reputed company, and prescription drug coverage
reputed company