Collections Analyst

Independence Blue Cross, LLC in; Philadelphia (Philadelphia County); Presencial; USD 70.000 - 90.000; Jornada completa

Descripción de la vacante

Independence Blue Cross in Philadelphia is seeking a Provider Claim Recovery Analyst to manage disputed provider overpayments and drive AR recoveries. You will collaborate with management, analyze data, and generate reporting to leadership.

The role requires healthcare industry experience and strong system skills. You'll work in a fast-paced environment, interface with providers and subscribers, and contribute to process improvements while maintaining accuracy and compliance.

Formación

• Bachelor’s degree in business or related field.
• 2+ years’ experience in the healthcare or health insurance industry.
• AR management experience strongly desired.
• Understanding of basic business acumen.
• Strong technical ability to employ systems to generate reporting.
• Ability to interface with internal and external customers at various levels.
• Willingness to work in a fast-paced, challenging environment.
• Detail oriented and organized with strong prioritization skills.
• Excellent communication with senior management, supervisors, peers and external providers.

Responsabilidades

• Collaborate with department management on goals, projects, and information sharing for an efficient operation.
• Complete daily tasks including financial adjustments, investigations of disputed claims overpayments, and data analysis with reconciliations.
• Manage a book of business including provider/subscriber overpayment recoveries.
• Identify opportunities to improve processes and reduce financial risk.
• Coordinate with third-party collections agencies to drive results for uncollectible Provider AR.
• Interact with providers and subscribers to resolve payment disputes.
• Assist in developing and preparing departmental reporting metrics and analytics.
• Generate and distribute reporting to management, key stakeholders and leadership.
• Create and maintain desk-level procedure documents.
• Share information across teams to reduce AR and risk.
• Document system limitations and coordinate with areas for technical solutions.

Conocimientos

AR management

Healthcare industry experience

Interfacing with customers

Attention to detail

Analytical skills

Educación

Bachelor’s degree in business-related field

Herramientas

Microsoft Applications

Descripción del empleo

Bring your drive for excellence, teamwork, and customer commitment to Independence. Join us as we renew and reimagine the future of health care. Together we will achieve our mission to enhance the health and well-being of the people and communities we serve.

At Independence, everyone can feel valued, supported, and comfortable to be themselves. Our commitment to equity means that all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. We stand together to speak out against injustice and to break down barriers to support a more inclusive and equitable workplace. Celebrating and embracing the diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

The Provider Claim Recovery Analyst's responsibilities include, but are not limited to:

• Collaborative interaction with department management regarding goals and objectives, special projects and general information sharing that leads to an effective and efficient operating department.
• Complete daily tasks that include financial adjustments, investigations on disputed claims overpayments, analyze provider data and complete reconciliations.
• Manage a book of business that includes claims overpayment recoveries (Provider/Subscriber).
• Responsible for identifying process improvement opportunities that can enhance quality and efficiency without sacrificing service.
• Working directly with third-party collections agencies to drive results for uncollectible Provider AR.
• Directly interact with providers and subscribers to resolve payment disputes.
• Assist in the development and preparation of departmental reporting metrics and analytics.
• Generate and distribute reporting to management, key stake holders and executive leadership.
• Create and maintain desk level procedure documents.
• Responsible for sharing information across the team and other business areas to reduce overall AR and limit financial risk.
• Document / prioritize system limitations and coordinate with respective areas to identify technical solutions or automation opportunities.

Self-sufficient in handling escalated cases with internal and external stakeholders

• Bachelor’s degree in business-related field is a plus.
• 2 or more years’ experience in the healthcare or health insurance industry.
• AR management experience is strongly desired.
• Understanding of basic business acumen is desired.
• Strong technical ability requires employ and manipulate systems to generate needed reporting, as well as to view team results.
• Must possess the ability to interface with internal and external customers at various levels.
• Willingness to work in a fast-paced, challenging environment.
• Demonstrates willingness to step outside normal business tasks to improve processes and reduce financial risk.
• Detail oriented and organized, with exceptional prioritization skills.
• Ability to effectively communicate with senior management, supervisors, peers and external providers.
• Proficient in Microsoft Applications.
• Understanding proven process improvement methodology and driving change management.
• Customer Focused.

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Must have an Android or iOS device which is compatible with the free Microsoft Authenticator app.

Inclusion and Belonging

At IBX, everyone can feel valued, supported, and comfortable to be themselves, and all associates have a fair opportunity to achieve their full potential. We put these principles into action every day by acting with integrity and respect. Celebrating and embracing diverse thoughts and perspectives that make up our workforce means our company is more vibrant, innovative, and better able to support the people and communities we serve.

About Our Company

Serving more than 8 million people nationwide, including 2.5 million in southeastern Pennsylvania, Independence Health Group — together with its subsidiaries — is the leading health insurance organization in the Philadelphia region. Our mission to build healthier lives for you, your family, and your employees shapes our actions and decisions every day.

At Independence, we see each of our members as an individual, with unique needs and concerns. We’re dedicated to harnessing the very latest ideas and technologies to deliver access to care that meets those needs and surpasses your expectations. For more information about Independence access our website at www.ibx.com . We’re revolutionizing health care, and our focus is on you!

IBX is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to their age, race, color, religion, sex, national origin, sexual orientation, protected veteran status, or disability.

Agency Disclaimer

All resumes submitted directly to anIndependence Blue Cross employee from a vendor via email, the Internet or in any other form without a valid written search agreement in place for this position from the Independence Blue Cross Family of Companies Human Resources Department will be deemed the sole property of Independence Blue Cross andthe Independence Blue Cross Family of Companies. Please note that no fee will be paid in the event the candidate is hired by Independence Blue Cross or the Independence Blue Cross Family of Companies as a result of the referral or through means other than our established process.

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