Insurance Recovery Analysts process commercial, governmental, and third-party liability medical claims for hospital clients. The role focuses on recovering maximum allowable medical fees efficiently, accurately, and in compliance with HIPAA and applicable laws.
Key responsibilities include investigating and negotiating claims, billing and following up for payment, identifying viable payers, obtaining supporting documents, maintaining aged accounts receivable, contacting patients and other involved parties, recovering reimbursement through coordination of benefits, appealing claims when needed, and completing special projects as assigned.
Minimum of 4 years of directly related industry experience.
Bachelor's degree in business or a related field, or 5 years of directly related experience in lieu of degree.
Strong knowledge of commercial insurance, government insurance, workers' compensation, motor vehicle liability, general liability, and claims processing systems.
Knowledge of medical and insurance terminology and coordination of benefits.
Experience with Emdeon/ChangeHealthcare, EPIC, CERNER, MEDITECH, or multiple-state claims handling is a plus.
Working knowledge of FACS or comparable management software.
Basic Microsoft Excel and Word skills.
Strong verbal and written communication skills, customer service skills, and the ability to work independently and as part of a team.
Location
Massachusetts, US
Employment Type
Full-time
Experience Level
Senior
Remote work allowed
No
Posted
1 month ago