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Westchester Medical Center Health Network

Payment Resolution Analyst

Westchester Medical Center Health Network, Valhalla, New York, United States, 10595

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Payment Resolution Analyst

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Westchester Medical Center Health Network .

Overview Job Summary: The Payment Resolution Analyst processes all out of network insurance claims to ensure appropriate payments are received, negotiates payments with payers, provides good faith estimates to potential patients and processes and follows up on independent dispute resolution appeals.

Responsibilities

Reconciles billing and payment data on an automated system to maintain and update receivable status on out of network payments posted on the patient\'s account.

Communicates with third party payers by means of correspondence or by telephone to start payment negotiation on accounts that are deemed underpaid per set guidelines.

Reviews payments to assess if account will be sent for independent dispute resolution.

Prepares and submits appeals for independent dispute resolution.

Negotiates with third party payors on underpayments.

Tracks outcomes.

Works collaboratively with other departments to ensure accuracy of patient billing.

Responsible for maintaining and implementing new process/procedures based on regulatory updates.

Any other responsibility as directed.

Qualifications/Requirements

Experience: 1 year billing and follow up experience in a hospital environment preferred

Education: High school or equivalency diploma and combination of years of experience, college education or healthcare certification equivalent.

Licenses / Certifications:

Other: Must possess strong organizational and communication skills, and Microsoft Office aptitude (Word/Excel/Outlook). Must be comfortable with data entry utilizing multiple patient access programs and software. Work effectively in a multitask, fast-paced environment prioritizing and completing tasks in a timely manner. Problem-solving skills and attention to detail to assess and resolve conflict in a timely manner. Proficient in oral and written communications.

Job details

Seniority level: Entry level

Employment type: Full-time

Job function: Accounting/Auditing and Finance

Industries: Hospitals and Health Care

Referral program: Referrals increase your chances of interviewing at Westchester Medical Center Health Network by 2x

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