Claims Research Analyst
1 week ago
Remote schedule.
Selected candidate must be local to the DMV area to work on-site in Washington, DC - 2 days per month plus for special projects.
Job Summary -Analyzes invoice with no adjudication status to facilitate timely reimbursement for 1 billion + annual billing of provider services. Reviews, researches, and corrects TES edits, eligibility and registration corrections. Ensures that claims meet billing guidelines for assigned carriers. Uses GE IDX ETM to ensure the claims status is changed to ensure successful resubmission in a timely manner.
Primary Duties and Responsibilities
Contacts third party payers as needed to resolve billing problems/claims processing delays.
Exemplifies Guest and Staff Relations standards in all activities in areas of service, resource utilization, high quality outcomes and effective communication and holds staff accountable for conformity with those standards in all activities.
Maintains billing manuals and reference documents for assigned third party carriers.Processes high volume claim submissions with an error rate of 10% and less.
Recommends and assists in implementation of manual and automated billing processes to enhance claim generation and submission process.
Researches and requests necessary billing information and documentation from provider/division billing contact/patient.
Resolves all No Activity invoices accurately and in a timely manner.
Responds to incoming mail from insurance carriers.
Reviews and resolves claim issues such as edits and registration edits in a timely manner.
Reviews claim forms to meet billing requirements as dictated by third party payers.
Reviews, processes, or reassigns appeals, charge correction, coding and provider enrollment rejections as required to achieve successful claim reimbursement.
Serves as resource to others related to assigned insurance carriers as needed.
Updates accounts in billing system.
Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards.
Complies with governmental and accreditation regulations.Minimum Qualifications
Education
High School Diploma or GED equivalent required
Experience
1-2 years medical billing environment required
GE IDX experience preferred
Knowledge, Skills, and Abilities
Knowledge of accounts receivable practices.
Strong organizational skills with the ability to process high volume services, with accuracy on a daily basis.
Skills in using computer and calculator.
Ability to examine documents for accuracy and completeness and prepare claims and other records according to detailed instructions.
Ability to work and thrive in team oriented, production and deadline driven work environment.
Verbal and written communication.
Why MedStar Health?
At MedStar Health, we understand that our ability to treat others well begins with how we treat each other. We work hard to foster an inclusive and positive environment where our associates feel valued, connected, and empowered.
We live up to this promise through:
Strong emphasis on teamwork -
our associates feel connected to each other and our mission as an organization.
In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
Strategic focus on equity, inclusion, & diversity -we are committed to equity for all people and communities.
We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
Comprehensive total rewards package -
including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.
About MedStar Health
MedStar Health is dedicated to providing the highest quality care for people in Maryland and the Washington, D.C., region, while advancing the practice of medicine through education, innovation, and research.
Our team of 32,000 includes physicians, nurses, residents, fellows, and many other clinical and non-clinical associates working in a variety of settings across our health system, including 10 hospitals and more than 300 community-based locations, the largest home health provider in the region, and highly respected institutes dedicated to research and innovation.
As the medical education and clinical partner of Georgetown University for more than 20 years, MedStar Health is dedicated not only to teaching the next generation of doctors, but also to the continuing education, professional development, and personal fulfillment of our whole team.
Together, we use the best of our minds and the best of our hearts to serve our patients, those who care for them, and our communities.
It's how we treat people.MedStar Health is an Equal Opportunity (EO) Employer and assures equal opportunity for all applicants and employees.
We hire people to work in different locations, and we comply with the federal, state and local laws governing each of those locations.
MedStar Health makes all decisions regarding employment, including for example, hiring, transfer, promotion, compensation, benefit eligibility, discipline, and discharge without regard to any protected status, including race, color, creed, religion, national origin, citizenship status, sex, age, disability, veteran status, marital status, sexual orientation, gender identity or expression, political affiliations, or any other characteristic protected by federal, state or local EO laws.
If you receive an offer of employment, it is MedStar Health's policy to hire its employees on an at-will basis, which means you or MedStar Health may terminate this relationship at any time, for any reason.
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