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Insurance Analyst - Insurance Department 915799

Company Name:
Vidant Health
About Vidant Medical Center
Vidant Medical Center is a fully accredited, 900+ bed regional referral facility encompassing a Level-1 Trauma Center and extensive inpatient and outpatient services including intensive and intermediate care, pediatrics, bariatrics, obstetrics, and gynecology, surgery, pain management and psychiatry.
Responsibilities
Process claims utilizing billing software containing payer specific edits. Review and resolves errors based on payer regulation and departmental policies including charge reconciliation prior to claim submission. For secondary & tertiary claims, populate applicable fields with the appropriate payment, coinsurance, deductible and reason codes. Submit valid claims daily to the third party payers. Documents all actions taken.
Receives daily confirmation reports from post-electronic transmission. Evaluates error reasons, correcting and revalidating claims for resubmission. Makes revisions to mainframe and billing systems and assigns the proper denial reason code for tracking. Documents all actions taken.
Review rejections and denials with appropriate actions being taken to correct or appeal. Updates all systems. Documents all actions taken.
Pursues collection on accounts not paid in greater than 25 days. Communicates with third party payers and patients in order to expedite payment or account resolution. Documents all actions taken.
Review managed care data for over and underpayments. Verifies discrepancy by evaluating and confirming data posted and contract terms. Submit appropriate documentation to support reconsideration of the claim.
Facilitate payment arrangements with non-contracted payers. Determines appropriate reimbursement methodology based on hospital service and term of payment.
Reviews payer bulletins and websites for changes in rules and regulations. Interprets and incorporates changes into billing and collection activities. Attends educational seminars and meetings.
Responds to all requests for documents required for timely claims adjudication and prompt patient customer service.
Performs in accordance with accepted procedure and responds to special requests by management in a timely and accurate manner.
Adheres to the policies and procedures. Uses tact and courtesy in all interactions including but not limited to staff, patients and payers. Promotes a positive image and supports management in goals and objectives. Handles inquiries andcomplaints discreetly and effectively
Minimum Requirements
High School plus 2 years or more of formal training or education in Health Occupations, Business or related or Associate College Degree
Windows based PC skills
More than 2 years but less than 3 years in Hospital or physician office billing experience. Third party experience. Patient Accounting or Cash Applications experience.
One year of related experience may be substituted for one year of education up to two years.
A four year degree in a health related field may substitute for one year of the required experience.
Apply here: http://tinyurl.com/pd8zlpc


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