Insurance Recovery Analyst

Paycom - ATS; Norwood (KY); On-site; USD 46,000 - 68,000; Full time

Job summary

CCS Companies is seeking an Insurance Recovery Analyst to manage medical claim billing across commercial, government, and liability lines. You will investigate, negotiate, and follow up to maximize reimbursements for hospital clients while maintaining HIPAA standards.

The role requires 4+ years in related work, experience with hosting systems like FACS, and strong knowledge of insurance terminology and COB. A bachelor's degree or equivalent experience is accepted along with relevant certificates.

Qualifications

• Bachelor's degree in business or related field; CCS may accept equivalent experience.
• 5+ years of directly related experience in medical insurance claims and billing.
• Experience with commercial, government, workers' compensation, and liability claims.
• FACS (ClaimAssists) or similar host system experience.
• Knowledge of medical terminology and coordination of benefits (COB).
• Proficiency with Microsoft Excel and Word; strong communication skills.

Responsibilities

• Investigates, negotiates, bills and follows up for payment on first and third‑party medical claims.
• Identifies payers, obtains IBs, UBs, and medical records when needed.
• Maintains HIPAA privacy and confidentiality.
• Contacts patients, payers, hospitals, attorneys and others to secure information for reimbursement.
• Appeals claims when applicable and meets team and department goals.
• Completes special projects as requested.

Skills

4+ yrs exp

Billing systems

Claims processing

COB knowledge

Phone communication

HIPAA compliance

Excel

Word

Interpersonal skills

Education

Bachelor's degree in business or related field

Insurance Institute Certificate

5 years experience in lieu of degree

Tools

FACS (ClaimAssists)

EMDEON/ChangeHealthcare

EPIC/CERNER/MEDITECH experience

Job description

Insurance Recovery Analysts are medical billers that are responsible for processing commercial, governmental and/or third-party liability (workmans compensation, general liability, and motor vehicle liability) medical claims. This position ensures that ClaimAssists clients (hospitals) recover the maximum allowable medical fees in the most timely, efficient, and confidential manner.ESSENTIAL FUNCTIONS:Investigates, negotiates, bills and follows-up for payment regarding first and third-party claims involving any and all coverages, liability, and legal issues.Identifies viable payers, obtains IBs, UBs, HCFAs, correspondence, and medical records when necessary.Maintains the highest level of privacy in accordance with HIPAA requirements and laws.Works their inventory by route while maintaining an acceptable level of aged accounts receivable.Contacts patients, payers, hospitals, attorneys, employers, and any other parties involved to collect the necessary information and ensure reimbursement for our client.Recovers maximum dollars for the hospital through coordination of benefits in a timely manner.Appeals claims when applicable.Meets monthly company, team, and individual goals, and all deadlines set by the Team Lead and Manager, Operations.Completes special projects, as requested.QUALIFICATIONS:Minimum of four (4) years of directly related industry experience.Emdeon/ChangeHealthcare billing experience is a plus.EPIC, CERNER and/or MEDITECH experience is a plus.Experience working claims in multiple states is a plus.Strong technical knowledge in one or more areas of commercial insurance, government insurance, workmans compensation, motor vehicle liability, general liability and claims processing systems.Knowledge of medical and insurance terminology.Knowledge of coordination of benefits.Working knowledge of FACS (ClaimAssists host system) or comparable management software system.Ability to speak confidently over the phoneBasic knowledge of Microsoft Excel and Word.Ability to provide quality customer service to all parties.Ability to work in a fast-paced environmentDemonstrated knowledge of state laws and insurance statutes.Excellent interpersonal and verbal/written communications skills.Highly motivated, self-starter, organized and detail-oriented.Ability to work well individually, as well as part of a team.Coachable: receptive to feedback, willing to learn, embraces continuous improvement, and responsive to change.Ability to maintain a predictable and consistent full-time work schedule.EDUCATIONAL REQUIREMENTS:Bachelors degree in business or related field.Insurance Institute Certificate(s) highly desirable.Five (5) years of directly related experience in lieu of degree.The CCS Companies is an Equal Opportunity EmployerThis document is considered CCS Proprietary and Confidential.