Revenue Cycle Analyst
4 weeks ago
Revenue Cycle Analyst - Administration - MSG 01928
Community Bridges, Inc. (CBI) is an integrated behavioral healthcare agency offering a variety of different programs throughout Arizona. CBI provides residential, outpatient, inpatient, patient-centered medical homes, medication-assisted treatment, and crisis services to individuals experiencing crisis, opioid use disorder, homelessness, and mental illness.
ESSENTIAL JOB DUTIES OR RESPONSIBILITIES
Review and analyze payer responses to determine appropriate claim adjudication.
Post payer responses and payments to billing system.
Interface with payers to resolve underpayments, recoupments and denials while maintaining timely filing deadlines.
Completely and accurately review and resolve payer rejections according to timely filing guidelines.
Responsible for rebilling claims after verifying and correcting authorizations, eligibility, coding, and claims data submitted.
Ensure accuracy to optimize reimbursement while adhering to regulations.
Prepares, submits, and tracks payer appeals and reconsiderations.
Write-off balances in accordance with CBIs write-off policy.
Handle incoming correspondence from payers by taking appropriate action per payer requests, including but not limited to preparing supporting documentation/records.
Scans documents when necessary into the system.
Coordinate with various departments to obtain necessary information/action to resolve rejections, underpayments, recoupments or denials.
Ensures appropriate resolution of all rejections, underpayments, recoupments, and denials within 45 days.
Works to ensure compliance with applicable industry rules and regulations.
Review patient bills for accuracy and completeness, and obtaining any missing information
Reconciliation of electronic batches.
Ensure that all month end deadlines are met.
Communicate findings and trends to manager for appropriate resolution.
Provide support for external audit requests, as needed.
Participate in various company, department and information services projects as assigned
Comply with all applicable Federal, State and local laws, regulations, and requirements as well as CBI policies and procedures in all aspects of job performance.
Meet or exceed department standards for production and quality.
Maintaining patient confidentiality as per the HIPAA guidelines.
All other duties and responsibilities as assigned
SUPERVISORY RESPONSIBILITIES
This position does not have supervisory responsibilities.
MINIMUM EDUCATION & EXPERIENCE REQUIRED
High School diploma, Associate Degree preferred.
3+ years experience with billing medical claims, behavioral claims knowledge is a plus.
Equivalent combination of education, training, and experience
LICENSES, CERTIFICATIONS, CREDENTIALS, REGISTRATIONS
Valid AZ Drivers License in good standing & clear Motor Vehicle Report.
OTHER SKILLS AND KNOWLEDGE REQUIRED
Minimum 3 years experience performing healthcare reimbursement, behavioral health insurance/billing or related work.
Experience in follow-up on rejections/denials and submission of appeals
Strong working knowledge of medical terminology.
Customer service skills with the ability to work in a team environment.
Must be highly organized and detail-oriented. Ability to work in a fast paced, rapidly changing environment.
Experience in MS Word, Excel and Outlook.
Must be able to type at least 40 WPM and possess a high school diploma or equivalent.
COMPLEXITY AND SCOPE OF POSITION
Demonstrates knowledge and competency to resolve outstanding claims that were inappropriately adjudicated. This position requires that the individual be organized, and task driven to monitor and resolve claims. Must obtain and apply payer requirements for authorizations, timely filing, and other payer specific edits.
CBI Offers an excellent benefits package
Medical, Dental, Vision, Disability, Life, Supplemental plans - Hospital indemnity/ Critical Illness, Pet Insurance, Dependent Care Savings, Health Care Savings, 401K with employer match - 100% vested upon enrollment, Generous PTO accrual, Wellness programs, Tuition Reimbursement and Scholarship Programs, incentives, and more
For the past four years, The Phoenix Business Journal has recognized CBI as one of the top ten healthiest mid-size employers in the Valley.
CBI treats patients from all different walks of life and believes in maintaining the dignity of human life. Recovery is possible
Qualifications
Skills
Preferred
Communication Skills
Novice
Team Work
Novice
Education
Required
High School or better.
Experience
Preferred
3 years:
Billing medical claims and behavioral claims knowledge
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