Senior Revenue Cycle Analyst (Medical Claims)

Position Summary:

The analyst is responsible for approving manual adjustments and patient refunds and resolving billing edits to ensure timely claim submission.

Reviews adjustment requests and determines validity of the adjustment through account and EOB review.Reviews patient refund requests to determine validity through review of account, related accounts and EOB.Analyze and resolve patient claims being held by billing edits. Reviews the APC Grouper, Ancillary, Overlap and Rapid Response reports daily for timely resolution of billing edits.Acts as a liaison and interacts with departments to obtain information needed to properly bill accounts based on the documentation in the medical record.Prepares and reviews work comp implant invoices to ensure accurate billing.Assist with late charge action plan templates.

QUALIFICATIONS

2+ years’ of relevant experience in processing Medical Claims.Strong working knowledge of third-party billing requirements to include Medicare, Medicaid, Commercial and Managed Care payors.Demonstrates a general knowledge of medical terminology, ICD-9, ICD-10 and CPT procedure codes relative to hospital practices, CPT4 and HCPCS.Displays strong knowledge of all business units including Patient Access, HIM, Case Management and Finance.

A leading fortune 500 Hospital and Healthcare company just opened it's Philippine office in Bonifacio Global City, Taguig. Be part of the pioneer shared services team and make a positive impact to the community.We are a community built on care. Our caregivers and supporting staff extend compassion to those in need, helping to improve the health and well-being of those we serve, and provide comfort and healing. Your community is our community.Our company is a healthcare services company headquartered in Dallas, Texas. We operate 65 hospitals and approximately 500 other healthcare facilities across the US. The company is listed in the NYSE.