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Claims Analyst - Lima, OH

Quick Facts
Company Name:HealthPro Medical Billing
Location:Lima, OH
Employment Type:Full Time
Category:Billing Operations
Pay:Based on Experience and Qualifications - Hourly
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Description

About HealthPro Medical Billing, Inc.

HealthPro Medical Billing is the trusted partner of choice for radiology and pathology practices, as well as imaging centers and other healthcare service providers throughout the United States. Now in business for over 30 years, our success is fully dependent on the service and results we provide our clients and the integrity we demonstrate along the way. Because building and maintaining client trust is essential to our business, we seek out talented medical billing professionals who share our commitment to quality.

We are looking for dynamic individuals to be a part of our team. We offer a flexible work schedule, competitive compensation and benefits, and a work-life balanced environment.

Employment Opportunity

HealthPro Medical Billing in Lima, OH is seeking a Claims Analyst to be a part of our Claims Analysis team.

Claims Analyst Summary of Responsibilities:

  • Complete quarterly reports, monthly reports, ad hoc reports
  • Run reports with the ability to format, prepare, and analyze data to respond to challenging questions.
  • Communicate with internal and external entities to obtain, interpret, and respond to data and data mining requests.
  • Provide critical support to clients, Operations team leads and the Leadership team, focusing on data analysis, monitoring of client activity and trending information including corporate and industry key performance indicators.
  • Demonstrate excellent research skills utilizing multiple authoritative sources to correlate information for accuracy.
  • Analyze data to identify trends and interpret results in the form of ratios, percentages, graphs, etc.
  • Calculate values to identify percent change, standard deviation, averages, etc.
  • Proactively analyze data on a routine basis to provide support for Client Services and Operations with detailed communication and professionalism.
  • Initiates research, concisely and accurately communicates areas of concern in a timely and professional manner.
  • Learn and utilize the valuation logic used by governmental and commercial payers for CPT codes as well as industry regulations to complete Contracted Payer Reimbursement Verification.
  • Learn and monitor governmental and industry regulations and programs (i.e. PQRS, MPPR, Place of Service/Location of Service, etc.).
  • Review new CPT codes entered into the system as a part of the CPT verification process.
  • Review and process denial write off requests via batch access in the billing system.
  • Complete non-coding related verification, monitoring and reporting across all areas of Operations to promote quality assurance.
  • Complete charge reversals (ERFs)
  • Assist with secondary support for provider enrollment functions such as payor enrollment applications, revalidations, EDI and EFT enrollment.

Qualifications:

  • Good listener to identify the need of the audience and have the ability to provide return communication in a way that their audience understands the data and the response.
  • Excellent organization skills for verbal or written presentation of complex information.
  • Excellent Excel and Power Point ability or technical aptitude.
  • Ability to facilitate a plan once developed.
  • Ability to balance and report at precise levels of detail.
  • Maintain a high level of accuracy and confidentiality regarding client data, operational statistics, and personnel related quality assurance measures.
  • Must be detail oriented, organized and possess good analytical skills.
  • Ability to collaborate with team members on more difficult requests to brainstorm and utilize the unique strengths of each team member to achieve maximum results beyond one person's ability.
  • Manage projects from start to finish with logical and thoughtful decision making that is timely and client minded.
  • Meet routine, recurring deadlines, and prioritizes urgent and ad hoc requests while exercising flexibility, excellent time management skills and composure under pressure.

 Education and Experience:

High school diploma or GED is required. Associate's degree or Bachelor's degree in Business Management, Healthcare Management or related area of study is preferred. Three to five years of industry related work experience and/or a customer service experience required. Equivalent combinations of work experience and education will be considered.