Position Overview
Are you skilled in processing hospital claims and manual data entry? We are seeking a talented Claims Processor/Revenue Cycle Analyst to join our team! In this role, you will analyze and monitor claims audit data across various platforms, ensuring accurate and appropriate reimbursement to healthcare providers. You will tackle payment variances and collaborate with internal and external teams to resolve issues.
Key Responsibilities
- Claims Analysis & Adjustment: Review, adjust, and reprice claims to ensure accurate reimbursement according to contractual agreements and payer guidelines.
- Pricing Structures: Develop and maintain accurate 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: Conduct detailed variance analysis to 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: At least 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 a difference in healthcare claims processing? Apply now to join our dynamic team!
To Apply
Click the Apply Online button, then:
- If you are currently registered with us, click the Log In button to apply for this job.
- If you are NOT currently registered, click the Create Account button to complete the application.
Employment Type: Full-Time