Analyst I - Reimbursement

Responsibilities

• Prepares and submits patient claims to appropriate third party payers.
• Reviews claims to ensure that payer specific billing requirements are met.
• Follows standard procedures and pre-established guidelines to complete tasks.
• Supports and adheres to the US Oncology Compliance Program, to include the Code of Ethics and Business Standards.
• Ensures claim forms are completely and accurately filled out.
• Updates and maintains patient billing data and ensures documents are current.
• Reviews patient charts for completeness.
• Enters charges, processes, and submits insurance claims to third party payer.
• Completes data entry of the charges into Practice Management System.
• Completes review of interface transactions and resolution of TES edits.
• Identifies and reports any payer trends, denial patterns, and delays to management.
• Adheres to confidentiality, state, federal, and HIPAA laws and guidelines with regards to patient's records and collections.
• Maintains strict confidentiality of patient and financial information in assigned area of responsibility.
• Performs other duties as requested or assigned.

Qualifications

• High school diploma or equivalent required.
• Minimum of two (2) years in healthcare reimbursement, managed care or finance; or equivalent combination of education and work experience.
• Proficiency with computer systems and Microsoft Office (Word and Excel) required.
• Working knowledge of state, federal, and third party claims processing preferred.
• Must successfully complete required e-learning courses within 90 days of occupying position.