Revenue Cycle Analyst-Insurance

Skyland Trail - Chamblee, GA

Full-time - Entry Level

Chamblee, GA

101-250 employees

Ambulatory Health Care Services

About the position

The Revenue Cycle Analyst - Insurance plays a crucial role in the daily operations of the Patient Accounts Department at Skyland Trail. This position requires exemplary customer service skills, as the analyst will interact with co-workers, the public, and various stakeholders including vendors and payers. The primary responsibility of the analyst is to assist in resolving claim underpayments or denials, ensuring that all assigned accounts are billed and followed up on in a timely manner according to established policies. The analyst will analyze account histories to expedite payments and improve cash flow, while also following up with payers regarding the collection of past due accounts, managing a minimum of 45 claims or dates of service per day. In addition to payment posting and timely billing, the Revenue Cycle Analyst will communicate effectively with the director to report problems and provide updates on the status of accounts. The role involves preparing documents, spreadsheets, or reports as requested, and ensuring that claim batches and payment processing adhere to departmental guidelines. The analyst will work closely with accounting staff for daily cash reconciliation and regularly meet with the team and director to discuss workflow issues and departmental concerns. A strong understanding of HIPAA standards and compliance is essential, as the analyst will monitor reports for compliance with expected standards and assist with client statement issues as needed. The position requires the initiation of billing on assigned claims through electronic formats, auditing claims for completeness, and maintaining control of claims billed and pending. The analyst will also follow up on unpaid claims over 30 days, analyze aging reports, and maintain documentation of all collection activities. The role demands a proactive approach to collection efforts, with the analyst submitting account adjustments and refund requests to the director as necessary, and resolving credit balance accounts monthly. Overall, this position is integral to ensuring the financial health of the organization and supporting the mission of Skyland Trail.

Responsibilities

• Assist in overall daily operations of the Patient Accounts Department.
• Exhibit exemplary customer service skills when dealing with co-workers, the public, and associated vendors.
• Assist in finding solutions to claim underpayments or denials.
• Responsible for payment posting, timely billing, and follow-up on assigned accounts until paid or adjusted according to policies.
• Analyze account history to expedite payment and improve cash flow.
• Follow up with payers regarding the collection of past due accounts, managing a minimum of 45 claims or dates of service per day.
• Communicate effectively with the director to report problems and provide follow-up on status.
• Prepare documents, spreadsheets, or reports as requested.
• Ensure claim batches and payment processing are performed within departmental guidelines.
• Work with accounting staff on daily cash reconciliation.
• Regularly meet with team and director to discuss problems and workflow issues.
• Possess in-depth knowledge of HIPAA standards and compliance.
• Monitor reports for compliance with expected standards.
• Assist with client statement issues as needed.
• Initiate billing on assigned claims in an expeditious manner through electronic format.
• Audit claims to ensure pertinent information is captured, including authorizations and clinical notes.
• Maintain control of claims billed and pending to ensure accountability for all assigned accounts.
• Follow up on all unpaid claims over 30 days.
• Analyze aging reports to identify details of open account balances.
• Maintain documentation of all collection activity.
• Advise director of workload problems that may prevent timely follow-up on accounts.
• Track unbilled claims weekly and notify director of trends/issues.
• Work EOB/ERAs daily to identify denials or short paid claims.
• Collaborate with other departments on eligibility issues and necessary documentation.
• Demonstrate professionally aggressive yet conscientious collection efforts.
• Submit account adjustments for director approval as appropriate.
• Submit completed refund request documentation to director within policy guidelines.
• Resolve credit balance accounts on a monthly basis.
• Perform all other duties as assigned by the director.

Requirements

• High School diploma or GED.
• 5+ years related experience in a high-volume healthcare setting with health insurance billing and AR related duties.
• Extensive knowledge of healthcare insurance billing.
• Exceptional understanding of payor-specific billing guidelines.
• Knowledge of Microsoft Excel, Word, and other IT systems relevant to the organization's workflow.
• Exceptional medical terminology and coding knowledge.
• Knowledge of HCFA and UB forms.
• Strong organizational skills.

Nice-to-haves

• Mental health billing experience preferred.

Benefits

• 403(b) matching
• Dental insurance
• Paid time off
• Employee assistance program
• Vision insurance
• Loan forgiveness