Payer Response Analyst (Full Time)

Description of Position

The Payer Response Analyst posts payments both electronically and manually, maintains accurate medical billing records and documents revenue from the patient payments and insurance reimbursement.

Supervision

Reports directly to the Payer Response Supervisor

Responsibilities and Duties

• Accurately analyzes payments posted on the previous day to perform Balancing on the Daily Balancing spreadsheet.
• Ability to evaluate transactions posted on an account to ensure all payments and adjustments posted are accurate and determine when an error has been made.
• Properly determines the appropriate area to assign claims needing additional follow up and assigns those based on each areas guidelines.
• Analyzes each Payer Explanation of Benefits in order to determine the next step for the account.
• Accurately processes electronic payments ensuring that all exceptions are evaluated, corrected, and posted.
• Accurately posts transactions based on assigned duties ensuring that keying is correct for all payments, adjustments, deductible & coinsurance assignments.
• Properly utilizes productivity tracking mechanisms.
• Works at or above the weekly set productivity standard and completes tasks in a timely manner.
• Appropriately prioritizes work queue in order to work highest priority first based on assigned subjects.
• Determines the appropriate area to assign claims needing additional follow up and assigns those based on each areas guidelines.
• Documents all information in the System following the Clear Concise Consistent method.
• Consistently monitors assignment to ensure that all steps necessary to assist the Team with achieving its goals have been taken.
• Writes clearly and informatively.
• Edits work for spelling and grammar.
• Varies writing style to meet needs.

Education and Work Experience

• Bachelors degree and two years experience in healthcare or related field
• Alternatively, at least 6 years or equivalent work in finance or healthcare related field
• Adequate keyboarding skills (40 words per minute typing rate); Basic computer skills.
• Strong organizational and communication skills, including ability to discuss medical issues.
• Negotiation skills including assertiveness and being proactive.
• Ability to handle multiple projects and issues at a time.

Physical Demands/Work Environment

• Work requires light duty lifting.
• Must be able to remain in a stationary position 50% of the time.
• Constantly operates a computer and other office machinery such as calculator, copy machine, and computer printer.
• Must be able to exchange accurate information with patient, family, peers and medical personnel.
• Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.