Insurance Analyst
1 week ago
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.
ssigns 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.
ttends, 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.
Education
Required: High school diploma, GED or higher level degree: This is the pay range that RightSourcing (a part of Magnit) reasonably expects to pay someone for this position, however, as a supplier your expected pay range may vary and/or include certain benefits like: Stipends (for clinical traveler workers only), Medical, Dental, Vision, 401K [include any compulsory benefits such as commissions, incentive bonuses, etc. if applicable]. Pay range (USD)18.78 hrly - (USD)27.98 hrly
Experience
Required: One (1) year of billing/collections experience, billing certification or prior successful internship/temporary assignment in a patient financial service setting
Preferred: Experience with managed care and Medicare/Medi-Cal Billing regulations"
-
Insurance Analyst
1 week ago
Rancho Mirage, United States InterSources Full timeDuties: 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...
-
Insurance Analyst II
3 weeks ago
Rancho Mirage, United States Eisenhower Health Full timeJob Objective: A brief overview of the position. Performs account review, follow-up and collections to include double recoupment, correspondence and credit balance resolution. Assists leadership with setting and maintaining goals within the department, including redirecting assignments and targeting aged and outstanding issues. Provides guidance and...
-
Insurance Analyst II
3 weeks ago
Rancho Mirage, United States Eisenhower Health Full timeJob Objective: A brief overview of the position. Performs account review, follow-up and collections to include double recoupment, correspondence and credit balance resolution. Assists leadership with setting and maintaining goals within the department, including redirecting assignments and targeting aged and outstanding issues. Provides guidance and...
-
IT Business Systems Analyst II
4 weeks ago
Rancho Cucamonga, California, United States Inland Empire Health Plan Full timeJob SummaryThe IT Business Systems Analyst II is a key member of our team, responsible for providing guidance to IT and Business Departments to resolve technical and project implementation deliverables for medium and complex projects. This role requires strong analytical skills, business acumen, and excellent communication skills to work effectively with...
-
Analyst II
3 weeks ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeOverviewWhat 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...
-
Analyst III
3 weeks ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeOverviewWhat 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 supervision of the Senior Director of Member Services, the Analyst III will assist in coordinating all regulatory requirements for audits....
-
Healthcare Claims Analyst
4 weeks ago
Rancho Cucamonga, California, United States Inland Empire Health Plan Full timeJob SummaryWe are seeking a skilled and detail-oriented Healthcare Claims Analyst to join our team at Inland Empire Health Plan. As a key member of our claims department, you will be responsible for conducting quality audits of claims, analyzing errors, and determining root causes for appropriate classification.Key ResponsibilitiesConduct quality audits of...
-
Underwriting Account Service Associate
4 weeks ago
Rancho Cordova, California, United States Zurich Insurance Company Ltd Full timeZurich North America is currently seeking an Underwriting Account Service Associate to join the National Accounts - Construction Underwriting team. As an Underwriting Account Service Analyst, you will support and work closely with experienced Underwriters in the review and analysis of risks.You will enjoy the opportunity to fully apply and hone your research...
-
Healthcare Analyst II
4 weeks ago
Rancho Cucamonga, California, United States Inland Empire Health Plan Full timeJob SummaryThe Analyst II - Population Health will provide support in the review, assessment, and development of business processes for all Population Health department programming. This role will span across Population Health and its associated programs, providing analytical support to PH programs and initiatives, such as Basic Population Health Management...
-
Senior Business Systems Analyst
1 month ago
Rancho Palos Verdes, California, United States Health Net Full timeBusiness Systems Analyst Job DescriptionAt Health Net, we're looking for a skilled Business Systems Analyst to join our team. As a Business Systems Analyst, you'll play a critical role in translating business requirements into functional and non-functional technical requirements. Your expertise will help our design and development teams build technical...
-
Rancho Cucamonga, United States Inland Empire Health Plan Full timeWhat You Can You 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 direction of the Quality Systems Leadership Team, the Healthcare Data Analyst II (HDA II) is responsible for leading various data and analysis...
-
Rancho Cucamonga, United States Inland Empire Health Plan Full timeWhat You Can You Expect!If the following job requirements and experience match your skills, please ensure you apply promptly.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 direction of the Quality Systems Leadership...
-
Analyst II
6 months ago
Rancho Cucamonga, CA, United States Inland Empire Health Plan Full timeWhat 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 direction of the Supervisor of Product System Configuration, the Analyst II – Product System Configuration is responsible for managing the more...
-
Board Certified Behavioral Analyst- Apple Valley
2 weeks ago
Rancho Cucamonga, United States Redwood Family Care Network Full timeJob DescriptionJob DescriptionChanging Lives Shaping The FutureBoard Certified Behavioral Analyst- Apple Valley - EBSH Home experienced Job Type: Full-timeLocation: Apple Valley, CA Salary Range: $87,000 - $92,000 annually Redwood Family Care Network is an innovative leader in delivering person-centered home and community-based services to...
-
JDE Business Analyst
4 weeks ago
Rancho Cordova, California, United States West Fraser Full timeJob Summary:The JD Edwards Business Analyst will work closely with the business, sales, and shipping teams to determine their requirements and collaborate with technical teams to facilitate changes. This role is responsible for working with business users to identify, document, and resolve issues arising from the use of JD Edwards Enterprise One Order to...
-
Healthcare Data Analyst I
4 days ago
Rancho Cucamonga, United States Inland Empire Health Plan Full timeOverviewWhat 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 direction of the Quality Systems Leadership Team, the Healthcare Data Analyst I - Quality Informatics (HDA I) is responsible for providing...
-
Behavioral Therapist
1 month ago
Rancho Cucamonga, California, United States Res-Care, Inc. Full timeJob SummaryWe are seeking a skilled Behavioral Therapist to join our team at SpringHealth Behavioral Health and Integrated Care. As a Behavioral Therapist, you will work with individuals with developmental disabilities to implement Applied Behavior Analysis (ABA) driven programs in their homes and community environments.Key ResponsibilitiesImplement ABA...
-
Behavior Therapist
4 weeks ago
Rancho Cucamonga, California, United States SpringHealth Behavioral Health and Integrated Care Full timeJob SummaryWe are seeking a skilled Behavior Technician to join our team at SpringHealth Behavioral Health and Integrated Care. As a Behavior Technician, you will play a vital role in implementing Applied Behavior Analysis driven programs for youth with developmental disabilities in their homes and/or a community environment.ResponsibilitiesImplement...
-
Behavior Therapist
4 weeks ago
Rancho Cucamonga, California, United States SpringHealth Behavioral Health and Integrated Care Full timeAbout the RoleWe are seeking a skilled Behavior Technician to join our team at SpringHealth Behavioral Health and Integrated Care. As a Behavior Technician, you will play a vital role in implementing Applied Behavior Analysis (ABA) driven programs for youth with developmental disabilities in their homes and/or community environments.Key...
-
Rancho Cucamonga, CA, United States Inland Empire Health Plan Full timeWhat You Can You 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 direction of the Quality Systems Leadership Team, the Healthcare Data Analyst II (HDA II) is responsible for leading various data and analysis...
