Healthcare Insurance Analyst

2 weeks ago

Sunnyvale, California, United States IntelliPro Group Inc. Full time
Job Overview

Position: Insurance Payer Specialist

Company: IntelliPro Group Inc.

Employment Type: Full-time/Contract

Location: Remote

Salary: Competitive

Key Responsibilities:

  • Conduct comprehensive analyses on health insurance payers regarding medical billing and reimbursement processes.
  • Investigate and document significant trends within the healthcare payer landscape.
  • Establish and clarify policies, coverage details, and payment rates for medical services.
  • Effectively communicate updates on policy changes to all relevant stakeholders.
  • Perform annual reviews and adjustments of insurance payment rates according to CPT/HCPCS coding.
  • Manage assigned projects and troubleshoot operational challenges.
  • Meet project deadlines in a dynamic and resource-constrained environment.
  • Develop a detailed dashboard outlining payer coverage specifics, including benefits and payment structures.
  • Strengthen relationships with payers by staying updated on policy modifications.
  • Ensure adherence to regulations established by healthcare authorities, including Medicare and state programs.

Qualifications:

  • Bachelor's degree in accounting, healthcare administration, finance, business, or a related discipline, with a minimum of 5 years of experience in an office or healthcare setting.
  • Expertise in CPT/ICD-10/HCPCS coding and electronic health record systems.
  • Familiarity with medical terminology and various insurance plans.
  • Proven experience in process enhancement, quality assurance, data analysis, and reporting.
  • Exceptional attention to detail and proficiency in managing diverse databases.
  • Leadership capabilities, with the skill to effectively present and advocate for payer knowledge.
  • Strong organizational, time management, and customer service abilities.
  • Analytical thinking and problem-solving skills.
  • Proficient in Google Workspace and Microsoft Office Suite.

About IntelliPro Group Inc.:

Founded in 2009, IntelliPro Group Inc. is a premier global provider of talent acquisition and human resources solutions. Our commitment to outstanding service, employee growth, and lasting partnerships sets us apart in the industry. With a robust international presence, we are leaders in the global talent solutions sector.

As a key facilitator connecting individuals with fulfilling career opportunities, IntelliPro is dedicated to understanding your professional aspirations. We are an Equal Opportunity Employer, embracing diversity and inclusivity. We do not discriminate based on various factors and are committed to welcoming candidates from all backgrounds and abilities. Discover more about our inclusive practices on our website.

Compensation: The salary for this position will be determined based on factors such as education, experience, location, certifications, and more. IntelliPro also provides a comprehensive benefits package, subject to eligibility.

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