Account Analyst I (Biller - Collector)
This position is designated as safety-sensitive and cannot be filled by a candidate who is a current user of medical marijuana. Flu vaccines are required.
About the role
Prepares accurate and complete medical claims/billings for timely submission to third-party payers. Responsible for follow-up and collection activities to assure prompt and proper payment from third-party payers. Responsible for knowledge of medical billing requirements and software products essential to performing job duties. Analyzes claims for payment, resolves denials, and identifies problem trends to work toward resolution.
Responsibilities
- Analyzes medical claims to assure they are complete, accurate, and have any required attachments before being filed to payer (clean claim).
- Expedites proper adjudication of claims by payer to maximize reimbursement and minimize older age accounts.
- Identifies claims that have not been adjudicated and assures they are adjudicated promptly.
- Analyzes reasons given for claims not being adjudicated and determines how to overcome lack of adjudication.
- Reviews adjudicated claims to assure they were properly adjudicated with the proper payment amount and that unpaid amounts are valid and properly categorized.
- Appeals claims that are improperly adjudicated so they are promptly corrected.
- Identifies problems and patterns, quantifies, reports, and resolves them.
- Establishes effective working relationships with internal and external customers to expedite creation of clean claims and prompt adjudication of claims.
- Communicates technical information accurately and effectively, both in writing and orally.
- Performs other duties as assigned.
Requirements
- High school diploma or GED (or equivalent).
- 2 years of experience in lieu of a diploma/GED.
Qualifications
Recommended: Bachelor’s degree in a related field of study.
Pay
Most new hires start between $19.30–$24.10 per hour, depending on experience and qualifications.
Schedule
Monday to Friday, 7:00 a.m. to 3:30 p.m. — Hybrid