Claims Research Analyst
4 weeks ago
General Summary of Position
MedStar Health has an opportunity for a Claims Research Analyst to join our team with the MedStar Physicians' Billing Services department. As a Claims Research Analyst, you will be responsible for analyzing invoices with no adjudication status to facilitate timely reimbursement for the annual billing of provider services. Reviews, research, and corrects TES edits, eligibility and registration corrections. Ensures that claims meet billing guidelines for assigned carriers. Uses Athena IDX to ensure the claim status is changed to ensure successful resubmission in a timely manner.
Remote schedule but selected candidate must be local to the DMV area to work on-site in Washington, DC 1 - 2 days per month plus additional days for special projects.
Primary Duties:
· Contacts third party payers as needed to resolve billing problems/claims processing delays.
· 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.
· Reviews and resolves claim issues such as edits and registration edits in a timely manner.
· Reviews, processes, or reassigns appeals, charge correction, coding and provider enrollment rejections as required to achieve successful claim reimbursement.
· Reviews claim forms to meet billing requirements as dictated by third party payers.
Qualifications:
· High School Diploma or GED equivalent required
· 1-2 years medical billing environment required
· Strong organizational skills with the ability to process high volume services, with accuracy on a daily basis.
· Skills in using computer and calculator. IDX experience preferred
· 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.
This position has a hiring range of $18.33 -
$29.96
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