Harvey, Louisiana
Health Care Payment Analyst Job Opening in Harvey, Louisiana - Indeed Hire and Margin Recovery Int'l LLC are partnering together to find A Health Care Payment Analyst to join their team in Harvey, LA. As a Technical Auditor on MRI?s Audit & Recovery team, you'll help build a growing organization, win over hospital, health system, and surgery center clients with superior customer service and service offerings. You?ll be a critical part of the growth of an emerging leader in hospital revenue cycle solutions. You will work alongside MRI team members to execute project plans which enhance the bottom-line profits for our clients.
The Technical Auditor will be responsible for activities focused on revising/creating queries designed at reviewing third party payments, including Managed Care, Medicare, and Medicaid, as it relates to hospital insurance reimbursement. This includes working directly with SQL and other proprietary systems to analyze and modify data, working with end-users to understand and clarify requirements, systemically modifying data sets, all while delivering bottom-line results for MRI's Audit & Recovery team.
Essential Duties and Responsibilities
Create and modify proprietary modeling tools to review and identify hospital accounts with which are due for additional reimbursement from insurance companies
Work with Audit & Recovery team members to improve existing and create new proprietary and SQL processes
Create process maps and documentation for review by entire MRI organization
Work with MRI management to refine one-time ad hoc processes into long-term, revenue generating processes that will benefit entire Audit & Recovery team
Document terms and provisions for managed care contracts between hospitals and insurance companies
Participate in internal client meetings, contributing to a greater understanding initiative progress
Coaches/Partners with other team members
Identify and research new placement concept opportunities
Assist in client reporting
Strict adherence to HIPAA privacy and security rules, including following MRI policy at all times
Ensures productivity and quality standards are met
As needed, fill in as an Auditor directly involved in revenue generation:
Identify and document underpayment root causes by contacting payers via phone and through review of client systems and account documentation
Submit written appeals detailing expected reimbursement and clearly outlining reasons for additional payment, including citation of contract language, policies, and industry standard in a persuasive manner
Through tracking processes, follow-up via telephone and payer websites on appealed accounts for receipt of appeal and payment processing/ resolution of accounts
Ensures that appeals for findings are prepared including appropriate documentation and sent to payer for review timely, accurately while ensuring all HIPAA/compliance and contractual rules and regulations are followed.
All other duties as assigned
KNOWLEDGE, SKILLS, ABILITIES
Strong analytical, technical, and creative problem-solving skills.
Demonstrated ability to analyze, understand, and communicate complex issues and trends.
Demonstrated interpersonal skills. Ability to clearly articulate goals and expectations to team members and communicate results to MRI Management.
Customer-service orientation with the ability to independently interact with a range of personalities and styles to establish effective relationships internally & externally.
A positive and optimistic attitude that is maintained despite tight deadlines and competing priorities.
Genuine enthusiasm for working for an evolving start-up with the ability to embrace new ideas.
Ability to consistently demonstrate high personal ethics, integrity, prudence, energy, initiative, and self-confidence.
Willingness to work an average of 45 hours per week.
EDUCATION / EXPERIENCE
Relevant professional experience within Hospital/Insurance industry as an Analyst preferred
Bachelor?s degree with concentration preferred
Expertise within the MS Office Suite including Excel, Word, Outlook, and Access preferred
COMPENSATION AND BENEFITS
Competitive salary commensurate on relevant experience
Paid time off and holidays
Paid health and dental
401(k) plan with employer match after one year of service
Job Type: Full-time
Required education:
Bachelor's
Required experience:
Hospital/Insurance Analyst: 3 years
Healthcare Reimbursement: 3 years
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