Claims Analyst- Remote

About the role

The Claims Analyst supports those interfacing and providing care at Lifepoint Health facilities, driving quality, scalability, and significant impact across the organization.

Responsibilities

• Accurately performs billing and collections for multiple facilities for all payors.
• Provide professional and technical support to staff across multiple departments.
• Respond to inquiries from insurance carriers, patients, and family members regarding billing and account balance questions.
• Monitor and review financial systems to ensure accurate revenue recognition and maintain appropriate accounts receivable levels aligned with payer mix and acuity.
• Collaborate with Utilization Management departments to ensure pre-certifications, authorizations, and appeals are completed accurately and on time.
• Perform effective and timely follow-up on insurance claims to secure appropriate reimbursement.
• Analyze explanations of benefits (EOBs), remittances, and explanations of payment (EOPs) to identify discrepancies or underpayments.
• Research and resolve claim issues.
• Prepare, submit, and track appeals for denied claims through resolution.
• Prepare for and actively participate in weekly Accounts Receivable (AR) meetings.

Requirements

• A high school diploma required; Associate degree preferred with 3-5 years of computerized medical billing experience required with behavioral healthcare experience preferred and working knowledge of Medicare/Medicaid and institutional billing requirements.
• Strong knowledge of Medicare/Medicaid guidelines and UB04 billing requirements.
• Proficiency in computerized medical billing systems.
• Ability to manage multiple facilities and payor types simultaneously.
• Strong analytical and problem-solving skills.
• Effective communication with internal teams and external stakeholders.
• Detail-oriented with strong organizational skills.
• Ability to work in a fast-paced, high-volume, production-based environment.
• Understanding of Hospital Revenue Cycle processes within a multi-facility healthcare environment.

Qualifications

• Must be authorized to work in the United States without employer sponsorship.

Skills

• Computerized medical billing systems.
• Medicare/Medicaid guidelines and UB04 billing requirements.
• Collaboration with Utilization Management departments.
• Financial analysis and reporting.
• Communication and interpersonal skills.
• Attention to detail.
• Time management and prioritization.

Benefits

• Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
• Financial Protection & PTO: Life, accident, critical illness, hospital indemnity insurance, short- and long-term disability, paid family leave and paid time off.
• Financial & Career Growth: Higher education and certification tuition assistance, loan assistance and 401(k) retirement package and company match.
• Employee Well-being: Mental, physical, and financial wellness programs (free gym memberships, virtual care appointments, mental health services and discount programs).
• Professional Development: Ongoing learning and career advancement opportunities.

Pay

Commensurate with experience.

Schedule

Days: M-F

Job Location Type

Remote