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Reimbursement Analyst

2 months ago

Alamogordo, New Mexico, United States Christus Health Full time
Job Summary

Christus Health is seeking a highly skilled Reimbursement Analyst to join our team. As a Reimbursement Analyst, you will play a critical role in ensuring accurate and timely reimbursement for our patients.

Key Responsibilities
  • Claims Review and Analysis

Conduct thorough reviews of payer EOBs to ensure payment accuracy, patient liability, and appeal grievances.

Appeal and Grievance Management

File appeals on underpayments and forward appeal letters to scanning for prompt resolution.

Reporting and Data Analysis

Generate reports from the Managed Care module to identify issues, including underpayments, total charge adjustments, missing calculations, and contract accuracy.

Payer Account Management

Assist management in identifying payer problem accounts and create a monthly Medicaid HMO underpayment report for the CFO.

Correspondence and Communication

Process incoming mail correspondence from payers within 3 business days and follow up with payers via phone and/or website as needed.

Accounting and Record-Keeping

Enter detailed notes explaining account activity in the Patient Accounts system, including expected payment calculations.

Trend Identification and Reporting

Identify payer trends for resolution and report them to the Director and/or Assistant Director of Patient Financial Services.

Team Collaboration

Assist the Reimbursement Specialist as needed and respond to patient inquiries, interdepartmental inquiries, payer requests, and emails within 2 business days.

Customer Service

Maintain courtesy and respect at all times when working with internal and external customers.

Requirements
  • Education

High School diploma or equivalent required.

Licenses and Certifications

Certified Heartsaver (C-Heartsaver) certification preferred.