Cincinnati, Ohio
Hospital Claims Analyst Job Opening in Cincinnati, Ohio - This position is primarily responsible for thorough review of managed care contracts and comparison of such contracts against health care claims to identify underpayments for the assigned client.
Review insurance contracts to gain thorough understanding of payment methodologies
Examine claims and calculate reimbursement based on contract terms to determine accuracy of payment through use of various reports and supporting documentation
Contact insurance companies to obtain missing information, explain and resolve underpayments and arrange for payment or adjustment processing on behalf of client
Prepare and submit correspondence such as letters, emails, online inquiries, appeals, adjustments, reports and payment posting
Build strong, lasting relationships with clients, payors and BLS personnel
Maintain regular contact with necessary parties regarding claims status including payors, clients, managers and other BLS personnel
Attend client, department and company meetings
Comply with federal and state laws, company policies and procedures
Job Requirements
High level organizational skills required
Minimum 2 years experience in operational setting, preferably in managed care or hospital patient accounts
High school diploma or equivalent
Computer proficiency including skills with Microsoft Windows, Microsoft Word and strong in Microsoft Excel
Experience working with ICD-9, CPT-4 and/or HCPCS coding systems
Knowledge of insurance submittal procedures and medical forms (including UB04 and CMS1500)
Experience performing account resolution with third party payors
Accounts receivable collections from payors (no self pay)
Ability to effectively identify and communicate payor trends
Ability to read and interpret an extensive variety of documents such as contracts, claims, instructions, policies and procedures in written (in English) and diagram form
Ability to calculate rates using addition, subtraction, multiplication and division
Excellent interpersonal and communication skills, strong team player and commitment to company values
Bottom Line Systems is a privately held company, founded in 1996 and has experienced tremendous industry growth in our healthcare WE'RE STILL GROWING!
BLS provides consultative services to increase revenue for Hospitals, IV Therapy Services and other Health Services. We strive to foster a team and family work environment; many of our employees have long tenure with the company, as they have found it to be a stable and rewarding place to work!
BLS offers a superior retention rate, competitive salary/benefits package. PLUS, we reward ALL of our associates by offering a company-wide incentive program.
Job Type: Full-time
Required experience:
: 2 years
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