Healthcare Insurance Analyst

1 week ago

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

Position: Insurance Payer Specialist

Company: IntelliPro Group Inc.

Employment Type: Full-time/Contract

Location: Remote

Salary: Competitive and commensurate with experience

Key Responsibilities:

  • Conduct thorough analysis of health insurance payers concerning medical billing and reimbursement processes.
  • Investigate and keep abreast of significant trends within the healthcare payer landscape.
  • Establish policies, coverage parameters, and payment rates for various medical services.
  • Effectively communicate any changes in policies to all relevant stakeholders.
  • Perform annual reviews and updates of insurance payment rates according to CPT/HCPCS coding.
  • Manage assigned projects and troubleshoot operational challenges.
  • Meet deadlines in a dynamic and resource-constrained project setting.
  • Develop a comprehensive dashboard detailing payer coverage, including benefits and pricing structures.
  • Strengthen payer relationships by remaining informed about policy updates.
  • Ensure adherence to regulations established by healthcare authorities, including Medicare and state programs.

Qualifications:

  • Bachelor's degree in accounting, healthcare administration, finance, business, or a related discipline, along with a minimum of 5 years of experience in an office or healthcare setting.
  • Expertise in CPT/ICD-10/HCPCS coding and electronic health record systems.
  • Solid understanding of medical terminology and various insurance plans.
  • Proven experience in process enhancement, quality assurance, data analysis, and reporting.
  • Exceptional attention to detail and capability to navigate diverse databases.
  • Leadership qualities, with the ability to represent Payer Knowledge both internally and externally.
  • Strong organizational, time management, and customer service abilities.
  • Effective problem-solving and strategic thinking skills.
  • Proficient in Google Docs, Sheets, Slides, and Microsoft Office Suite.

About IntelliPro Group Inc.:

Founded in 2009, IntelliPro Group Inc. is a premier global provider of talent acquisition and human resources solutions. Our commitment to outstanding service, employee growth, and long-lasting partnerships sets us apart in the industry. With a robust presence across multiple countries, we are leaders in the global talent solutions sector.

At IntelliPro, we are dedicated to connecting individuals with fulfilling career opportunities while understanding their professional aspirations. As an Equal Opportunity Employer, we celebrate diversity and inclusivity, ensuring no discrimination based on various factors. We believe in embracing candidates from all backgrounds and abilities.

Compensation Package: The salary for this position will be determined based on factors such as education, experience, location, certifications, and more. IntelliPro also provides a comprehensive benefits package, subject to eligibility.

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