Healthcare A/R Analyst – Third-Party Billing & Reimbursement

Care New England; Warwick (RI); On-site; USD 42,000 - 60,000; Full time

Job summary

Care New England is seeking a Third Party Analyst to proactively manage and analyze accounts receivable. You will monitor current and past-due balances, resolve denied or unpaid claims, and collaborate with patients, providers, and insurance carriers to streamline billing processes.

Reporting to the Supervisor of A/R Management, you will support reporting and trend analysis, act as a liaison for billing issues, and help maintain regulatory compliance under HIPAA.

Qualifications

• High school diploma required.
• Minimum of two years of related experience in a healthcare environment or accounts receivable.
• Excellent interpersonal and communication skills.
• Strong typing skills and attention to detail.
• Solid understanding of insurance and governmental billing guidelines.
• Proficiency in documenting account activity and maintaining accurate records.

Responsibilities

• Track and maintain accounts receivable by aging categories.
• Review third-party credits to determine if adjustments, refunds, or recoups are needed.
• Communicate with insurance carriers, patients, and staff to resolve claim reimbursements.
• Manage secondary balances and denied/unpaid claims past contractual deadlines.
• Apply established policies and procedures for charity care, discounts, and adjustments.
• Accurately record account history and actions in systems within specified timeframes.
• Notify supervisor of denial trends or other A/R issues.
• Prepare reports and provide insight into accounts receivable trends.
• Follow insurance, state, and federal regulations, as well as internal policies.
• Safeguard patient confidentiality under HIPAA standards.
• Promptly handle phone calls, emails, and mail from insurance carriers and patients.
• Deliver excellent customer service when interacting with patients, providers, and insurers.
• Maintain positive relationships with internal and external stakeholders.
• Prioritize tasks to meet deadlines.
• Identify and recommend improvements to billing, workflow, or claims processes.
• Maintain familiarity with hospital contracts and payment policies to ensure consistent reimbursement.
• Collaborate with peers and management to achieve departmental objectives.
• Contribute ideas and feedback during team meetings.
• Assist coworkers as needed to optimize performance.
• Engage in relevant training, workshops, and professional development.
• Stay current on healthcare billing regulations and payer guidelines.
• Maintain punctual attendance and professional conduct.
• Adhere to dress code and appearance guidelines.
• Perform other duties asassigned by leadership.

Education

High school diploma

Job description

Care New England is seeking a Third Party Analyst to proactively manage and analyze accounts receivable. You will monitor current and past-due balances, resolve denied or unpaid claims, and collaborate with patients, providers, and insurance carriers to streamline billing processes.

Reporting to the Supervisor of A/R Management, you will support reporting and trend analysis, act as a liaison for billing issues, and help maintain regulatory compliance under HIPAA.