Insurance Analyst II-Clinic Billing Services

# Insurance Analyst II-Clinic Billing ServicesCategoryAdministrative SupportScheduleFull TimeJob NumberR0271526ShiftDayLocationRancho Mirage,CA92270Hours8 Hour Shift\*DepartmentClinic Billing ServicesSalary Range$20.71-$31.46 / hour\* For 10 hour and 12 hour shifts this is the average hourly rate which includes overtime when a non-exempt employee works over 8 hours.* Share Job:* Email**Job Description:****Education:****Licensure/Certification:****Experience:****Essential Responsibilities:*** Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.* Manages new accounts, on a daily basis, by working within Receivables Workstation. Interfaces with other departments within the hospital, when appropriate, to obtain information necessary to process or resolve claims. Contacts patient and/or account guarantor to solicit payment on account.* Works all accounts listed in the Follow-Up queue, on a daily basis to promote collection of accounts. This will include telephoning the payer, messaging or identifying the claim on the payers’ Internet websites.* Manages account inventory on a timely basis to promote payment and resolution of all accounts as instructed by management.* Stays current on all payer requirements by reading bulletins, reviewing provider handbooks, accessing websites, etc.* Processes incoming correspondence, including signature letters, denials, prior authorizations and additional information necessary to process the claim.* Records newly identified insurance plans and facilitates the account processing of new plan in accordance with pre-billing policies and procedures.* Records accurate and definitive notes in the electronic account file that depict the current status of account, issues with account and anticipated date of resolution.* Escalates account management to Supervisor when issues arise, if needed.* Ensures PFS management is kept up to date with contract, payer or system changes and/or issues.* Assigns a status code to each worked account to enable account tracking, statistical data gathering and audit activities.* Manages new credit balance accounts every day and prepares adjustments or refunds to zero the account balance.* Handles special projects as directed by management e.g. high dollar accounts, accounts over* Maintains productivity standards by payer assignment.* Reviews denial, payor rejection, and any other necessary reports to determine strategy in decreasing payor denials, clearing house rejections and delayed payments* Manages Commercial Insurance, Medicare credits and Medicare quarterly credit balance reports to ensure timely resolution of refunds and balance rectification.* Manages priority account inventory in a timely manner to promote payment and resolution of all accounts as instructed by management.* Regularly analyzes account inventory aged greater than* Provides analysis on aged inventory for future checks and balances and timely resolution to PFS Management Staff and Director.* Processes incoming hard copy explanation of benefits and reacts appropriately to resolve the accounts.* Obtains and records “Promise to Pay” amounts on a daily basis that are consistent with the cash collection goals.* Identifies work unit issues and participates in solutions and problem solving by working with supervisor and staff members.* Attends, in-house training and attends classes pertaining to Federal and State billing regulations as well as Compliance Issues and Guidelines as requested.* Participates in Payer webinar and training sessions to maintain latest knowledge on billing, coding and reimbursement practices; monitors updates with Insurance Payers and relays information to management, trainers and co-workers effectively.* Performs other job related tasks as assigned.* Knowledge of the Federal Fair Debt Collection Practices Act* Strong knowledge of payer contracts, interpretation, policies and procedures* Ability to support and train staff on Insurance billing, collections policies/processes, system processes* Strong financial, mathematical and analytical skills* Strong knowledge of Microsoft Office, voicemail and Epic* Strong knowledge of contract reimbursement methodology and proration* Knowledge of managed care, Medicare/Medi-Cal Billing regulations* Strong knowledge of medical terminology* Knowledge of rules and regulations of third party payers* Ability to interpret payer contracts and reimbursement practices by payer and state by state regulations* Ability to handle multiple projects/tasks at the same time and prioritize workload* Effective communication, organizational and problem-solving skills* Strong customer service and problem solving skills* Basic knowledge of ICD-10, CPT and HCPC coding* Ability to operate basic office equipment ie copiers, fax machines and calculators* Knowledge of database system and experience with internet applications* Excellent time management skills* Strong windows knowledge and keyboarding skills* Knowledge of computer based claims management### Eisenhower Health offers a generous benefits package and a matched retirement plan.Employees are eligible to participate in a benefits program designed to make a difference for you and your family. #J-18808-Ljbffr