Healthcare Billing Analyst

1 week ago

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

Company Background

IntelliPro Group Inc. is dedicated to enhancing healthcare billing and reimbursement processes. We are seeking a skilled professional to conduct comprehensive analyses of health insurance payers and manage intricate changes that impact our revenue cycle for services such as Remote Patient Monitoring and Medical Nutrition Therapy.

Position Summary

Key Responsibilities

  • Conduct thorough analyses of health insurance payers related to medical billing operations.
  • Research and stay updated on trends within the healthcare payer landscape.
  • Establish and define payer policies, coverage options, and reimbursement rates.
  • Communicate policy updates to relevant stakeholders in a timely manner.
  • Lead projects and address operational challenges effectively.
  • Meet project deadlines in a dynamic work environment.
  • Create and maintain a payer coverage dashboard detailing benefits and rates.
  • Enhance relationships with payers by remaining informed about policy modifications.
  • Ensure adherence to all applicable regulations and guidelines.
  • Participate in revenue cycle management initiatives.
  • Follow up on claims denials and coverage discrepancies.
  • Identify opportunities for revenue enhancement through trend analysis.
  • Maximize revenue capture while minimizing losses.
  • Stay informed about billing regulations and compliance standards.
  • Conduct audits and data clean-up processes.
  • Provide training and support regarding payer coverage.
  • Implement strategies aimed at reducing claim denials and improving billing accuracy.
  • Collaborate with IT departments to enhance billing efficiency.
  • Maintain comprehensive documentation of billing activities.
  • Work collaboratively with internal teams to achieve objectives.
  • Ensure compliance with HIPAA regulations.
  • Act as a key resource for payer-related knowledge.
  • Perform additional related duties as required.

Qualifications and Skills Required

  • Bachelor's degree in a relevant discipline with a minimum of 5 years of experience.
  • Familiarity with coding practices and electronic health record (EHR) systems.
  • Strong understanding of medical terminology and various insurance plans.
  • Experience in process improvement and data analysis methodologies.
  • Demonstrated integrity, confidentiality, and attention to detail.
  • Effective leadership and communication abilities.
  • Capability to work independently and manage priorities efficiently.
  • Robust problem-solving skills.
  • Proficient in using Google Docs and Microsoft Office Suite.

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