Insurance Analyst II

2 weeks ago

Waltham, MA, United States Fresenius Medical Care Full time

PURPOSE AND SCOPE:
The Insurance Analyst is responsible for evaluating and managing reimbursement opportunities to ensure accurate and timely revenue recovery. This role involves cross-functional collaboration, documentation management, and analytical oversight of accounts receivable trends to support revenue integrity. The analyst facilitates case resolution through effective communication, auditing, and reconciliation of payer-related issues, contributing to the financial health and operational efficiency of the organization.

PRINCIPAL DUTIES AND RESPONSIBILITIES:
• Intake, evaluate, and organize reimbursement opportunities across various referral types and departmental placements.
• Communicate, collaborate, and coordinate with internal teams such as Managed Care, Revenue Cycle, Revenue Analytics and others to ensure timely and accurate handling of specialized cases.
• Compile, track, and submit required documentation to support case reviews, approvals, or escalations.
• Respond to inquiries and facilitate communications across departments to support case resolution and workflow continuity.
• Monitor and audit AR and adjustment trends (credit and debit) to ensure revenue integrity through proper follow-up, reimbursement, and payer contract compliance opportunities.
• Reconcile identified cases within outstanding AR, ensuring alignment with accepted resolutions or departmental strategies.
• Maintain accurate updates and documentation in system records to support case progression from intake to resolution, including tagging, comments, and follow-up tracking.
• Intake and review settlement or resolution files, assess impact on open AR, and communicate findings to appropriate teams for next steps.

PHYSICAL DEMANDS AND WORKING CONDITIONS:
The physical demands and work environment characteristics described here are representative of those an employee encounters while performing the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

EDUCATION:
High School Diploma required

EXPERIENCE AND REQUIRED SKILLS:
1 - 2 years' related experience.
General computer skills with working knowledge of word processing, spreadsheet, and email applications.
Detail oriented with good analytical and organizational skills.
Good interpersonal skills with the ability to work cohesively within a team environment.
Excellent oral and written communication skills to effectively communicate with customers and all levels of management.

The rate of pay for this position will depend on the successful candidate's work location and qualifications, including relevant education, work experience, skills, and competencies.

Annual Rate: $52,000.00 - $79,000.00

Benefit Overview: This position offers a comprehensive benefits package including medical, dental, and vision insurance, a 401(k) with company match, paid time off, parental leave.

Fresenius Medical Care maintains a drug-free workplace in accordance with applicable federal and state laws.
EOE, disability/veterans

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