Clinical Financial Analyst
2 weeks ago
Job Overview
Becoming a Clinical Financial Analyst - BioPlus Specialty Pharmacy at Elevance Health is an exciting opportunity to make a meaningful impact on the healthcare industry. Our team is dedicated to delivering exceptional services and improving lives, and we're looking for talented professionals like you to join us.
About the Job
This role involves working with patient account files to ensure accuracy and completeness, maximizing reimbursement, and appealing denials. As a Clinical Financial Analyst, you will be responsible for reviewing and preparing billings for submission to insurance carriers and Medicare/MediCal, as well as managing and maintaining third-party accounts. Your excellent communication skills will be essential in responding to patient, insurance carrier, and internal/external inquiries.
Key Responsibilities
- Reviews patient account files to ensure accuracy and completeness
- Prepares and reviews billings for submission to primary/secondary insurance carriers and/or Medicare/MediCal
- Collects and decreases assigned Accounts Receivable, focusing on high-value accounts
- Manages and maintains third-party accounts
- Responds to patient, insurance carrier, and internal/external telephone inquiries
- Completes all denial and correspondence daily
- Prepares and submits refund requests to insurance carriers
- Re-bills claims when not paid properly
Requirements
To succeed in this role, you'll need a high school diploma or equivalent and a minimum of 2 years of experience in billing and appeals processes in Medicare/MediCal, including medical office experience. Knowledge of ICD-9 and CPT-4 coding is highly preferred.
Benefits
We offer a comprehensive benefits package, including market-competitive salary, merit increases, paid holidays, Paid Time Off, and incentive bonus programs (unless covered by a collective bargaining agreement), medical, dental, vision, short and long-term disability benefits, 401(k) + match, stock purchase plan, life insurance, wellness programs, and financial education resources.
Compensation & Location
The estimated annual salary for this position is $65,000-$80,000, depending on your level of experience and qualifications. This role is based in Las Vegas, NV, and requires candidates to reside within 50 miles or a 1-hour commute each way from a relevant Elevance Health location.
About Us
Elevance Health is a health company dedicated to improving lives and communities – and making healthcare simpler. We are a Fortune 25 company with a longstanding history in the healthcare industry, seeking leaders at all levels who are passionate about making an impact on our members and the communities we serve.
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