Insurance Analyst I-Patient Financial Services

Eisenhower Medical Center; Rancho Mirage (CA); On-site; USD 52,000 - 76,000; Full time

Benefits offered by this job

Benefits package

Matched retirement plan

Job summary

Eisenhower Health is seeking an Accounts Receivable/Billing Specialist to support the hospital's revenue cycle. You will work within Receivables Workstation and collaborate with various departments to ensure timely claim processing and payment resolution.

The role requires strong customer service, attention to detail, and knowledge of medical terminology to interpret payer contracts and guidelines. Daily tasks include contacting patients, following up on denials, and maintaining accurate records.

Qualifications

• Ability to handle multiple accounts and maintain accuracy in processing claims.
• Strong communication and problem-solving skills for patient interactions and payer follow-ups.
• Knowledge of medical terminology and payer requirements to resolve denials and questions.

Responsibilities

• Manage new accounts and follow up on claims to collect payment.
• Interface with hospital departments to obtain information needed to process or resolve claims.
• Contact patients or guarantors to solicit payment on accounts.
• Follow up daily on payer websites and via phone to promote collection of accounts.
• Maintain accurate notes in the electronic account file and track status.

Skills

Customer service

Problem solving

Medical terminology

Payer contracts

Regulatory guidelines

Data entry

Interdepartmental communication

Tools

Receivables Workstation

Job description

Located in the heart of the Coachella Valley, you have access to resort-style living and world-class amenities throughout Southern California.

• Demonstrates compliance with Code of Conduct and compliance policies, and takes action to resolve compliance questions or concerns and report suspected violations.
• Manages new accounts, on a daily basis, by working within Receivables Workstation; interfaces with other departments within the hospital, when appropriate, to obtain information necessary to process or resolve claims; contacts patient and/or account guarantor to solicit payment on account.
• Works all accounts listed in the Follow-Up queue on a daily basis to promote collection of accounts; includes telephoning the payer, messaging or identifying the claim on the payers’ Internet websites.
• Manages account inventory on a timely basis to promote payment and resolution of all accounts as instructed by management.
• Stays current on all payer requirements by reading bulletins, reviewing provider handbooks, accessing websites, etc.
• Processes incoming correspondence, including signature letters, denials, prior authorizations and additional information necessary to process the claim.
• Records newly identified insurance plans and facilitates the account processing of new plan in accordance with pre-billing policies and procedures.
• Records accurate and definitive notes in the electronic account file that depict the current status of account, issues with account and anticipated date of resolution.
• Escalates account management to leadership when issues arise, if needed.
• Ensures leadership is kept up to date with contract, payer or system changes and/or issues.
• Assigns a status code to each worked account to enable account tracking, statistical data gathering and audit activities.
• Manages new credit balance accounts every day and prepares adjustments or refunds to zero the account balance.
• Handles special projects as directed by leadership e.g. high dollar accounts, accounts over 180 days old, etc.
• Attends, in-house training and attends classes pertaining to Federal and State billing regulations as well as Compliance Issues and Guidelines as requested.
• Maintains productivity standards by payer assignment.
• Performs other duties as assigned.
• Ability to handle multiple projects/tasks at the same time and prioritize workload
• Strong customer service and problem solving skills
• Knowledge of Medical Terminology
• Ability to operate basic office equipment ie copiers, fax machines and calculators
• Knowledge of database systems and internet applications
• Strong windows knowledge and keyboarding skills
• Knowledge of computer based claims management
• Ability to interpret payer contracts and federal and state regulatory guidelines
• Ability to prioritize tasks and manage time efficiently to meet deadlines

Eisenhower Health offers a generous benefits package and a matched retirement plan.

Employees are eligible to participate in a benefits program designed to make a difference for you and your family.

From the beginning, this organization formed a culture based on strong values, commitments and a passion for service and professional excellence.

What Our Nurses Say

One of my very favorite things about working at Eisenhower Health is the culture on inclusivity that we have and a strong base for evidence-based practice.

Lori

One of the greatest things about working as a nurse at Eisenhower Health is how much support you get from Administration. We keep on improving the process here. It's a fantastic place to work.

My favorite thing about working at Eisenhower Health is the camaraderie within my unit and with the different departments.