Pre-Claims Analyst

2 weeks ago

San Antonio, Texas, United States Texas Healthcare Solutions Inc Full time

Key Responsibilities

  • The Pre-Claims Analyst adheres to all legal and ethical standards concerning the agency's products and services.
  • The Pre-Claims Analyst ensures compliance with established policies and procedures.
  • The Pre-Claims Analyst reviews account documentation and takes appropriate actions as directed.
  • The Pre-Claims Analyst assists in identifying inconsistencies or discrepancies between invoices, receipts, and payments.
  • The Pre-Claims Analyst supports other departmental requirements as necessary.
  • The Pre-Claims Analyst performs tasks with precision, requiring minimal supervision.
  • The Pre-Claims Analyst operates within the financial objectives of the organization.
  • The Pre-Claims Analyst develops and maintains accurate records and company documentation.
  • The Pre-Claims Analyst identifies issues as they arise and proposes solutions for swift resolution.
  • The Pre-Claims Analyst communicates effectively with business office and clinical staff.
  • The Pre-Claims Analyst is attuned to the needs of clients, families, physicians, staff, and support services.
  • The Pre-Claims Analyst engages in training and professional development programs to enhance skills and knowledge.
  • The Pre-Claims Analyst fosters a positive work environment at all times.
  • The Pre-Claims Analyst performs additional duties as required or assigned.

Minimum Qualifications

  • At least one year of relevant experience or experience in home health.
  • Clinical background knowledge (MA, CNA, LVN) is preferred but not mandatory.
  • Proficiency in contact management software (Outlook, Word, Excel, PowerPoint) is required.
  • Experience or training in human relations, customer service, time management, and organizational skills is essential.

Knowledge Requirements

  • Ability to communicate effectively through oral and written means.
  • Proficient in reading, writing, speaking, and understanding the English language.
  • Basic understanding of Medicare, Medicaid policies, and private insurance.
  • Demonstrated excellent organizational abilities.
  • Able to make independent decisions when necessary.

Professional Standards

  • Maintains and ensures compliance with HIPAA regulations.
  • Accountable to the Administrator regarding availability and performance.
  • Maintains positive relationships with patients, physicians, referral sources, regulatory agencies, and staff.
  • Adheres to the company dress code.
  • Participates in annual reviews and departmental training as required.

Additional Information

  • The candidate must not have a record of any crime, offense, or misdemeanor as defined in the Texas Billing Code.
  • The candidate is expected to uphold high personal and professional ethical standards.
  • The candidate agrees to comply with the company's Credo and Behavioral Expectations.

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