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Senior Revenue Cycle Analyst (Medical Claims)

2022-10-06 19:56菲律宾3760
区域:Metro Manila (NCR)Taguig
行业:Healthcare
职位:Practitioner / Medical Asst
部门:
人数:若干
性质:Full Time
性别:Male
婚姻:No marital status restrictions
学历:Open to all levels
经验:不限
年龄:18岁以上
待遇:面议

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.
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