Insurance Analyst

1 week ago

Rancho Mirage, United States eTeam Full time

Job Title: Insurance Analyst

Location: Rancho Mirage, CA 92270

Duration: 3 months + possible of extension


Duties:

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. This will include 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 Supervisor when issues arise, if needed.

Ensures PFS management 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 management e.g. high dollar accounts, accounts over 180 days old, etc.

Maintains productivity standards by payer assignment.

Reviews denial, payor rejection, and any other necessary reports to determine strategy in decreasing payor denials, clearing house rejections and delayed payments

Manages Commercial Insurance, Medicare credits and Medicare quarterly credit balance reports to ensure timely resolution of refunds and balance rectification.

Manages priority account inventory in a timely manner to promote payment and resolution of all accounts as instructed by management.

Regularly analyzes account inventory aged greater than 90 days to promote payment and resolution of all accounts in an effort to decrease AR days.

Provides analysis on aged inventory for future checks and balances and timely resolution to PFS Management Staff and Director.

Processes incoming hard copy explanation of benefits and reacts appropriately to resolve the accounts.

Obtains and records “Promise to Pay” amounts on a daily basis that are consistent with the cash collection goals.

Identifies work unit issues and participates in solutions and problem solving by working with supervisor and staff members.

Attends, in-house training and attends classes pertaining to Federal and State billing regulations as well as Compliance Issues and Guidelines as requested.

Participates in Payer webinar and training sessions to maintain latest knowledge on billing, coding and reimbursement practices; monitors updates with Insurance Payers and relays information to management, trainers and co-workers effectively.

Performs other job related tasks as assigned.


Skills:

Licensure/Certification

N/A


Experience Required:

Three (3) years of experience in medical billing or collections


Preferred:

Experience with managed care and Medicare/Medi-Cal Billing regulations

"Knowledge of Compliance Regulations and Medical Billing and Coding

Customer Service and Communication

Time Management and Organization

Teamwork and Collaboration"


  • Insurance Analyst

    2 weeks ago

    Rancho Mirage, United States eTeam Full time

    Job Title: Insurance AnalystLocation: Rancho Mirage, CA 92270Duration: 3 months + possible of extensionDuties: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....

  • Insurance Claims Examiner

    4 days ago

    Rancho Mirage, California, United States IDR, Inc. Full time

    Insurance Analyst Job DescriptionIDR, Inc. is seeking a skilled Insurance Analyst to join our team in Rancho Mirage, CA. As an Insurance Analyst, you will play a crucial role in analyzing and processing insurance claims and denials, ensuring compliance with Medicare/Medi-Cal Billing regulations.Key Responsibilities:Analyze and process insurance claims and...

  • Insurance Claims Specialist

    4 days ago

    Rancho Mirage, California, United States eTeam Full time

    Job Title: Insurance AnalystLocation: RemoteDuration: 3 months + possible extensionJob Summary:We are seeking an experienced Insurance Analyst to join our team at eTeam. The successful candidate will be responsible for managing new accounts, processing claims, and ensuring compliance with regulatory requirements.Key Responsibilities:Manage new accounts and...

  • Insurance Claims Examiner

    4 days ago

    Rancho Mirage, California, United States IDR, Inc. Full time

    IDR, Inc. is seeking a skilled Insurance Analyst to join our team in Rancho Mirage, CA. As a key member of our team, you will be responsible for analyzing and processing insurance claims and denials, drafting and sending appeals, and ensuring compliance with Medicare/Medi-Cal Billing regulations.Key Responsibilities:Analyze and process insurance claims and...

  • Insurance Claims Examiner

    4 days ago

    Rancho Mirage, California, United States Eisenhower Health Full time

    Job SummaryWe are seeking a highly skilled Insurance Analyst I to join our team at Eisenhower Health. As a key member of our Patient Financial Services department, you will be responsible for managing new accounts, resolving claims, and ensuring compliance with regulatory requirements.Key ResponsibilitiesManage new accounts and resolve claims in a timely and...

  • Speech Language Pathologist

    2 months ago

    Rancho Mirage, United States Pioneer Healthcare Services Full time

    Pioneer Healthcare Services is seeking a Speech Language Pathologist for a skilled nursing facility in Rancho Mirage, CA for a 13-week contract with the possibility to extend. The ideal SNF SLP will have a minimum of 1 year experience in the geriatric population. New grads are encouraged to apply. This can be a travel or a local assignment. Responsibilities...

  • Behavioral Analyst

    3 weeks ago

    Rancho Cucamonga, California, United States Redwood Family Care Network Full time

    Join Our Team as a Board Certified Behavioral AnalystRedwood Family Care Network is a leading provider of home and community-based services for individuals with intellectual and developmental disabilities. We are seeking a highly skilled Board Certified Behavioral Analyst to join our team in Whittier.About the RoleAs a Board Certified Behavioral Analyst, you...

  • Behavioral Analyst

    3 weeks ago

    Rancho Cucamonga, California, United States Redwood Family Care Network Full time

    Job Title: Board Certified Behavioral Analyst- WhittierRedwood Family Care Network is seeking a highly skilled Board Certified Behavioral Analyst (BCBA) to join our team in Whittier. As a BCBA, you will be responsible for providing ongoing consultation using principles of Applied Behavior Analysis (ABA) to support individuals with developmental...

  • Behavioral Analyst

    1 month ago

    Rancho Cucamonga, California, United States Redwood Family Care Network Full time

    About the RoleWe are seeking a highly skilled Behavioral Analyst to join our team at Redwood Family Care Network in Apple Valley, CA.Job SummaryThe successful candidate will be responsible for providing ongoing consultation using principles of Applied Behavior Analysis, designing and implementing behavior support plans, and conducting functional behavior...

  • Business Systems Analyst II

    2 weeks ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    Job Title: Business Systems Analyst IIJoin Inland Empire Health Plan (IEHP) as a Business Systems Analyst II and contribute to the success of our organization. As a key member of our team, you will be responsible for analyzing business needs and developing solutions to improve our systems and processes.Key Responsibilities:Analyze business requirements and...

  • Analyst II

    3 months ago

    Rancho Cucamonga, United States Inland Empire Health Plan Full time

    Overview: What you can expect! Find joy in serving others with IEHP! We welcome you to join us in healing and inspiring the human spirit and to pivot from a job opportunity to an authentic experience! Under the general direction of leadership among the Population Health (PH) team, the Analyst II - Population Health (Analyst II - PH) will provide support...

  • Board Certified Behavioral Analyst

    4 weeks ago

    Rancho Cucamonga, California, United States Redwood Family Care Network Full time

    Job Title: Board Certified Behavioral Analyst - WhittierWe are seeking a highly skilled Board Certified Behavioral Analyst to join our team at Redwood Family Care Network in Whittier. As a BCBA, you will play a critical role in providing person-centered home and community-based services to individuals with intellectual and developmental disabilities.About...

  • Healthcare Data Analyst II

    2 weeks ago

    Rancho Cucamonga, California, United States IEHP Full time

    Job Title: Healthcare Data Analyst IIAt IEHP, we're committed to healing and inspiring the human spirit of our members. As a Healthcare Data Analyst II, you'll play a critical role in leading various data and analysis efforts for our Clinical and Provider departments, programs, and quality activities.Key Responsibilities:Lead analysis and reporting efforts...

  • Board Certified Behavioral Analyst

    3 weeks ago

    Rancho Cucamonga, California, United States Redwood Family Care Network Full time

    Job Title: Board Certified Behavioral Analyst - WhittierRedwood Family Care Network is seeking a highly skilled Board Certified Behavioral Analyst to join our team in Whittier. As a key member of our team, you will be responsible for providing ongoing consultation using principles of Applied Behavior Analysis.Job Summary:Design, implement, write, and...

  • Board Certified Behavior Analyst/BCBA Position

    2 weeks ago

    Rancho Cucamonga, California, United States ADEAF Inc. Full time

    Job Title: Board Certified Behavior Analyst/BCBAADEAF Inc. is seeking a highly skilled Board Certified Behavior Analyst (BCBA) to join our team. As a BCBA, you will play a crucial role in providing top-notch care and support to families of children with Autism and related disabilities.Job Summary:We are looking for a dedicated and compassionate BCBA to work...

  • Board Certified Behavioral Analyst

    3 weeks ago

    Rancho Cucamonga, California, United States Redwood Family Care Network Full time

    Job Title: Board Certified Behavioral Analyst - Apple ValleyJoin Redwood Family Care Network, an innovative leader in delivering person-centered home and community-based services to individuals with intellectual and developmental disabilities. We are seeking a highly skilled Board Certified Behavioral Analyst (BCBA) to provide ongoing consultation and...

  • Board Certified Behavioral Analyst- Apple Valley Position

    3 weeks ago

    Rancho Cucamonga, California, United States Redwood Family Care Network Full time

    Job Title: Board Certified Behavioral Analyst- Apple ValleyRedwood Family Care Network is seeking a highly skilled Board Certified Behavioral Analyst to join our team in Apple Valley, CA. As a Behavioral Analyst, you will play a critical role in providing ongoing consultation using principles of Applied Behavior Analysis, designing, implementing, writing,...

  • Financial Analyst II

    4 days ago

    Rancho Cucamonga, California, United States Inland Empire Health Plan Full time

    OverviewWe are seeking a highly skilled Financial Analyst II to join our team at Inland Empire Health Plan. As a key member of our finance department, you will play a critical role in the preparation and maintenance of our operating budget, monthly variance analyses, and database queries and reports.Key ResponsibilitiesPrepare monthly operational reports and...

  • Board Certified Behavioral Analyst

    4 weeks ago

    Rancho Cucamonga, California, United States Redwood Family Care Network Full time

    Job Title: Board Certified Behavioral Analyst - Apple ValleyWe are seeking a highly skilled Board Certified Behavioral Analyst to join our team at Redwood Family Care Network in Apple Valley, CA.About the Role:The successful candidate will be responsible for providing ongoing consultation using principles of Applied Behavior Analysis, designing,...

  • Software Developer/Analyst

    2 months ago

    Rancho Dominguez, United States Santa Monica Seafood Full time

    Position: Software Developer/Analyst Outstanding opportunity to join our small, but talented IT team providing end-user computer support and business systems support for a family-owned, mid-size (and rapidly growing) seafood distribution and retail company. This position will join our Business Systems Analysis (BSA) team in supporting, integrating, and...