About The Role
We're seeking a detail-oriented Claims Processor/Revenue Cycle Analyst to join a leading healthcare organization. If you have experience in processing hospital claims and manual data entry, we'd love to hear from you!
Position Overview
As a Revenue Cycle Analyst, you will play a crucial role in analyzing and monitoring claims audit data across multiple platforms. Your work will involve various follow-up activities to ensure accurate and appropriate reimbursements to healthcare providers. You will be responsible for identifying payment variances and collaborating with internal and external teams to resolve these issues.
Key Responsibilities
- Claims Analysis & Adjustment: Review, adjust, and reprice claims to ensure reimbursement accuracy per contractual agreements and payer guidelines.
- Pricing Structures: Develop and maintain precise pricing structures to support competitive and profitable billing strategies.
- Error Identification: Detect and resolve errors in reconciliation files across different platforms and partners.
- Contract & Reimbursement Analysis: Perform detailed variance analysis and identify overpayments or billing errors.
- Data Analysis: Analyze claims data, generate reports, and support trend analysis to ensure accurate revenue cycle data.
- Regulatory Compliance: Stay updated on billing protocols, federal and state regulations, and internal procedures.
- Confidentiality: Maintain strict confidentiality of medical records and personal information.
Flexible Hours
Choose any 8-hour shift between Monday and Friday, 8 am to 5 pm.
Essential Skills & Qualifications
- Experience: Minimum of 3 years in claims processing, repricing, pricing configuration, or provider maintenance.
- Education: High School Diploma or equivalent (verification required).
- Technical Skills: Proficiency in MS Office (Word, Excel, PowerPoint, Outlook) and Windows operating systems.
- Knowledge: Strong understanding of healthcare revenue cycle, claims reimbursement, ICD-10 coding, and CMS guidelines.
- Analytical Skills: Excellent problem-solving abilities and attention to detail.
Additional Requirements
- Ability to work independently and think critically.
- Demonstrated knowledge of billing and coding regulations.
- Strong analytical skills and the ability to deliver results in a fast-paced environment.
Why Join Us?
- Career Growth: Direct hire opportunity with a reputable healthcare organization.
- Flexibility: Enjoy the benefits of remote work after initial training.
Ready to make an impact in healthcare claims processing? Apply now to join our dynamic team!
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Employment Type: Full-Time