Insurance Claims Analyst (Full-time, Monday - Friday, 8:00am-4:30pm)

Washington Regional Medical Center; Fayetteville (AR); Vor Ort; USD 42.000 - 54.000; Vollzeit

Zusammenfassung

Washington Regional Medical Center in Northwest Arkansas seeks an Insurance Claims Analyst to review, process, and analyze medical insurance claims for accuracy and compliance. You will verify patient information, check billing and coding for ICD-10 and CPT, and communicate with providers and internal departments to resolve issues.

The role requires strong analytical skills, attention to detail, and experience in hospital billing systems.

Qualifikationen

• High School diploma or GED required.
• 2+ years of billing/claims experience in hospital or clinic setting preferred.
• Basic knowledge of ICD-10 and CPT coding and MS-DRG coding methodology.

Aufgaben

• Analyze insurance claims for accuracy, completeness, and policy compliance.
• Verify patient information and check for billing/coding errors.
• Investigate and resolve discrepancies by communicating with providers and internal departments.
• Follow up on outstanding AR using provided worklists and payer portals.
• Ensure timely reimbursements and maintain detailed claims records and reports.
• Serve as liaison with providers, patients, and internal teams to resolve issues.

Kenntnisse

Healthcare billing

Claims analysis

MS Office

Medical terminology

ICD-10 coding

CPT coding

Ausbildung

High School diploma or GED

Tools

MS Office

Jobbeschreibung

Organization Overview, Mission, Vision, and ValuesOur mission is to improve the health of people in the communities we serve through compassionate, high-quality care, prevention, and wellness education. Washington Regional Medical System is a community-owned, locally governed, non-profit health care system located in Northwest Arkansas in the heart of Fayetteville, which is consistently ranked among the Best Places to live in the country. Our 425-bed medical center has been named the #1 hospital in Arkansas for five consecutive years by U.S. News & World Report. We employ 3,200+ team members and serve the region with over 40 clinic locations, the region’s only Level II trauma center, and five Centers of Excellence - the Washington Regional J.B. Hunt Transport Services Neuroscience Institute; Washington Regional Walker Heart Institute; Washington Regional Women and Infants Center; Washington Regional Total Joint Center; and Washington Regional Pat Walker Center for Seniors.Position SummaryThe role of the Insurance Claims Analyst reports to the assigned Insurance Billing Manager. This position reviews, processes, and analyzes medical insurance claims for accuracy and compliance with policies, investigating discrepancies and ensuring timely payments to providers. This position is responsible for verifying patient information, checking for coding errors (like ICD-10 and CPT), effectively and efficiently communicating with healthcare providers and internal departments, and maintaining detailed records. This position requires strong analytical and problem-solving skills, a keen eye for detail, and familiarity with medical billing and claims management software.Essential Position ResponsibilitiesAnalyze insurance claims to ensure accuracy, completeness, and compliance with policy guidelines.Verify patient information and check for errors in billing and coding.Investigate and resolve discrepancies, such as claim denials or billing issues, by communicating with providers and internal departments.Provide timely and efficient follow-up on all outstanding AR using assigned ATB worklist reports, using various systems, including Payor portals, Payor phone inquiries and/or written communicationsEnsure claims are processed efficiently and that reimbursements are paid correctly and on time.Apply knowledge of healthcare industry policies, regulations, and medical billing codes (like ICD-10 and CPT) to ensure correct billing practices.Maintain detailed records of claims and prepare reports on claims data, trends, and financial performanceMaintain AR collection of claims at less than 30 days of account ageServe as a liaison with healthcare providers, patients, and internal departments to answer questions and resolve issues.QualificationsEducation: High School graduate or GEDLicensure and Certifications: N/AExperience:Previous billing and claims experience within a hospital and/or clinic business office with 2+ year experience, preferred.Basic working knowledge of the MS Office suite of software, and the ability to operate standard office equipment.Broad knowledge of medical terminology, medical collections, MS-DRG coding methodology, ICD-10 and CPT coding, preferred.Work Environment: This position will spend 80% of time sitting while performing work in a standard office environment and 20% of time standing and/or walking while pushing, pulling, lifting, and/or carrying up to 50 lbs.Notice: This job description is designed to provide an overview of the essential and principal duties and responsibilities of the position. The job description is not designed or intended to cover or set forth a comprehensive listing of all activities, duties or responsibilities that are required of the employee. Washington Regional reserves the right in its absolute discretion to change duties, responsibilities or activities or assign new duties, responsibilities, or activities at any time with or without notice. Employees may be directed to perform job-related tasks other than those specifically presented in this description.