Insurance Analyst I-Clinic Billing Services
- Eisenhower Medical Center
- Rancho Mirage, California
- Full Time
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Located in the heart of the Coachella Valley, you have access to resort-style living and world-class amenities throughout Southern California.
- Job Objective
- Qualifications
- Responsibilities
- Essential Skills
Job Objective:
Performs account review, follow-up and collections to include double recoupment, correspondence and credit balance resolution.
Job Description:
Education:
Required: High school diploma, GED or higher level degreeRequired: High school diploma, GED or higher level degree Licensure/Certification: N/A Experience: Required: One (1) year of billing/collections experience, billing certification or prior successful internship/temporary assignment in a patient financial service setting
Preferred:
Licensure/Certification:
N/A
Experience:
Required: One (1) year of billing/collections experience, billing certification or prior successful internship/temporary assignment in a patient financial service setting
Preferred: Experience with managed care and Medicare/Medi-Cal Billing regulations
Essential Responsibilities:
- Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
- Manages new accounts, on a daily basis, by working within Receivables Workstation; interfaces with other departments within the hospital, when appropriate, to obtain information necessary to process or resolve claims; contacts patient and/or account guarantor to solicit payment on account.
- Works all accounts listed in the Follow-Up queue on a daily basis to promote collection of accounts; includes telephoning the payer, messaging or identifying the claim on the payers' Internet websites.
- Manages account inventory on a timely basis to promote payment and resolution of all accounts as instructed by management.
- Stays current on all payer requirements by reading bulletins, reviewing provider handbooks, accessing websites, etc.
- Processes incoming correspondence, including signature letters, denials, prior authorizations and additional information necessary to process the claim.
- Records newly identified insurance plans and facilitates the account processing of new plan in accordance with pre-billing policies and procedures.
- Records accurate and definitive notes in the electronic account file that depict the current status of account, issues with account and anticipated date of resolution.
- Escalates account management to leadership when issues arise, if needed.
- Ensures leadership is kept up to date with contract, payer or system changes and/or issues.
- Assigns a status code to each worked account to enable account tracking, statistical data gathering and audit activities.
- Manages new credit balance accounts every day and prepares adjustments or refunds to zero the account balance.
- Handles special projects as directed by leadership e.g. high dollar accounts, accounts over
- Attends, in-house training and attends classes pertaining to Federal and State billing regulations as well as Compliance Issues and Guidelines as requested.
- Maintains productivity standards by payer assignment.
- Performs other duties as assigned.
Essential Skils:
- Ability to interpret payer contracts and federal and state regulatory guidelines
- Ability to prioritize tasks and manage time efficiently to meet deadlines
- Ability to handle multiple projects/tasks at the same time and prioritize workload
- Strong customer service and problem solving skills
- Knowledge of Medical Terminology
- Ability to operate basic office equipment ie copiers, fax machines and calculators
- Knowledge of database systems and internet applications
- Strong windows knowledge and keyboarding skills
- Knowledge of computer based claims management
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Eisenhower Health offers a generous benefits package and a matched retirement plan.
Employees are eligible to participate in a benefits program designed to make a difference for you and your family.
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A Culture of Positivity and Support
From the beginning, this organization formed a culture based on strong values, commitments and a passion for service and professional excellence.
What Our Nurses Say
One of my very favorite things about working at Eisenhower Health is the culture on inclusivity that we have and a strong base for evidence-based practice.
Lori
Neonatal Nurse
One of the greatest things about working as a nurse at Eisenhower Health is how much support you get from Administration. We keep on improving the process here. It's a fantastic place to work.
Richard
Nursing Supervisor
My favorite thing about working at Eisenhower Health is the camaraderie within my unit and with the different departments.
Jennifer
Registered Nurse
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