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Healthcare Insurance Analyst
2 months ago
Position Title: Insurance Payer Specialist
Employment Type: Full-time/Permanent
Salary Range: $60,000 - $80,000 annually
Job ID: #139980
Position Summary:
This role is pivotal in conducting thorough evaluations of health insurance payers concerning medical billing and reimbursement processes. The specialist will oversee all facets of payer analysis, ensuring effective communication and management of intricate payer and industry modifications that influence the revenue cycle for Remote Patient Monitoring, Chronic Care Management, and Medical Nutrition Therapy services.
Key Responsibilities:
- Conduct detailed assessments of health insurance payers related to billing and reimbursement.
- Stay informed on healthcare payer trends and policy updates.
- Provide stakeholders with timely updates on policy alterations and annual payment adjustments.
- Execute projects and address operational challenges within set timelines.
- Create and maintain a comprehensive payer coverage dashboard.
- Foster and uphold relationships with payers while ensuring compliance with regulations.
- Oversee the complete revenue cycle, including claim submissions and denial follow-ups.
- Perform data audits, facilitate reimbursements, and analyze revenue patterns.
- Deliver training on payer coverage and document relevant meetings.
- Devise strategies to enhance claim acceptance rates and minimize denials.
- Collaborate with IT to optimize billing and revenue processes.
- Maintain organized billing records and monitor payment statuses.
- Support various departments while ensuring adherence to HIPAA regulations.
- Act as the primary resource for payer research.
- Carry out additional related tasks as required.
Qualifications:
- Bachelor's degree in accounting, healthcare administration, finance, business, or a related discipline, coupled with over 5 years of experience in an office or healthcare setting.
- Familiarity with CPT, ICD-10, and HCPCS coding systems, as well as EHR platforms.
- Strong grasp of medical terminology and various insurance plans.
- Experience in process enhancement, quality assurance, data analysis, and payer policy research.
- Commitment to confidentiality and privacy standards.
- Meticulous attention to detail and capability to work with diverse databases.
- Leadership qualities, with the ability to convey payer knowledge effectively.
- Self-motivated and capable of working independently, with excellent verbal and written communication skills.
- Strong organizational and time management abilities to prioritize workflow effectively.
- Proficient in problem analysis and strategic solution development.
- High level of computer literacy, including proficiency in Google Docs, Sheets, Slides, and Microsoft Office Suite.
About IntelliPro Group Inc.
Established in 2009, IntelliPro Group Inc. is a prominent player in talent acquisition and HR solutions. Our dedication to providing exceptional service to clients, nurturing employee development, and forging lasting partnerships distinguishes us in the industry. With a global footprint spanning the USA, China, Canada, Singapore, Philippines, UK, India, Netherlands, and Germany, we are at the forefront of global talent solutions.
Compensation: The compensation for the successful candidate will be determined based on various factors, including education, experience, location, job responsibilities, and certifications. IntelliPro also offers a comprehensive benefits package, subject to eligibility.
