EOB/Payment Analyst

5 days ago


Reno, Nevada, United States Saint Mary's Regional Medical Center Full time

Overview:

Saint Mary's Regional Medical Center is a leading healthcare provider in Northern Nevada, offering a comprehensive range of inpatient, outpatient, and ancillary services. As a trusted community partner, we strive to deliver exceptional patient care and outcomes.

Responsibilities:

  • Under the supervision of the Director, the Payment Review Specialist position is responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received.
  • Utilizing complex regulations, guidelines, and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement of Hospitals receivables.
  • Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment.
  • Utilizes and applies the appropriate State and Federal regulations in order to assure compliance in payment practices.

Qualifications:

  1. Minimum three years hospital billing and collection experience.
  2. Medical and Insurance terminology essential.
  3. Knowledge of CPT, ICD-9, HCPCS coding structures.


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