Jr Insurance Benefits Analyst

Cape Cod Healthcare Inc; Hyannis (MA); Hybrid; USD 30,000 - 40,000; Full time

Job summary

Cape Cod Healthcare in Hyannis, MA is seeking a Jr Insurance Benefits Analyst to support financial clearance within 48 hours of office visits. You will work with physician practices, insurers, and revenue cycle teams to secure payments and improve workflows.

Responsibilities include troubleshooting, process-improvement participation, and ensuring accurate patient registrations and authorizations across departments. Hybrid work options may apply.

Qualifications

• Associate degree preferred; high school diploma or GED required.
• Experience in a hospital revenue cycle or patient access is desirable.
• Proficiency with major hospital information systems is preferred.

Responsibilities

• Troubleshoot and evaluate work product, suggest improvements.
• Participate in process improvement initiatives to enhance cash flow.
• Attend management meetings and assist with special projects.
• Coordinate with Patient Access and Scheduling teams to ensure accurate registrations.
• Verify insurance eligibility and authorizations, update EMR data as needed.
• Maintain compliance with state and federal regulations and payer requirements.

Skills

Interpersonal skills

Problem solving

Critical thinking

Education

Associate Degree

High School Diploma or GED

Tools

Epic

Siemens

Job description

Job Description - Jr Insurance Benefits Analyst (260902-50025705)

Job Description

Jr Insurance Benefits Analyst - ( 260902-50025705 )

Purpose of Position : To financially clear all scheduled patients within 48 hours of their office visit and/or procedure. Resolve issues with accounts due to errors with authorizations, registration and eligibility. The job responsibilities include working effectively with the interdisciplinary team of Physician Offices, Insurance Companies, and CCHC Revenue Cycle to assure the protection and recovery of all revenues associated with services provided by CCHC. Assists with the review, analysis, development, and implementation of Process Improvement changes for the department to improve efficiency and workflow.

Description

1. Troubleshoot and evaluate work product of staff, make recommendations to management and assists with implementing changes.

2. Participate with management in strategizing for Process Improvement initiatives to improve cash flow.

3. Attend and participate in management meetings.

4. Assists management on special organizational projects for CCHC.

5. Provide input and feedback for employee evaluations.

6. Work collaboratively with Patient Access Managers, Scheduling Managers, Business Office Managers, Vendors and Customers across the enterprise to ensure that Registrars and Schedulers are fully capable of using technology to properly register our patients.

7. Assists with review of financial clearance and registration procedures and ensure effective communication with physician practices, patients and internal departments.

8. Work with department managers to continuously identify and correct issues identified by reporting.

9. Assist Patient Access Managers with Quality Control assessments of their staff related to eligibility and pre-registration errors.

10. Verifying insurance eligibility using available technologies, payer websites, or by phone contact with third party payers. Working in accordance with required State and Federal regulations and CCHC policies.

11. Contact patients as needed to gather demographic and insurance information, and updates patient information within the EMR as necessary.

12. Ensure correct insurance company name, address, plan, and filing order are recorded in the patient accounting system.

13. Processes outgoing referrals to specialists outlined by the patient’s insurance plans in a timely manner.

14. Utilize payer websites and/or Epic/Experian to process, obtain and verify insurance referrals.

15. Utilizing the incoming referral work queue will request, obtain and link insurance referral authorizations to upcoming specialty appointments as outlined by the patient’s insurance plan in a timely manner.

16. Track, document and communicate the status of referrals as they move through the referral process, ensuring proper follow-up, documentation and communication when the referral has been completed.

17. Maintain core competency and current knowledge of regulatory payer authorization and eligibility requirements.

18. Obtain and verify authorizations to ensure payment for services provide through CCHC.

19. Work accounts in assigned work queues to resolve billing errors and edits to ensure all claims are filed in a timely manner.

20. Follow-up and work registration/authorization claim denial work queues to identify and take the appropriate action to fix errors for claim resubmission to payers.

21. Maintain close coordination with Practice Managers, Clinical/Front End staff, and Physicians to advise of any changes or updates to insurance payer requirements.

22. Responds to all practice inquiries and questions about insurances, referrals, and authorizations.

23. Meets and maintains daily productivity and quality standards established in departmental policies.

24. Assists the department, work unit and/or fellow staff members by cross-covering for absences, participating in special projects, and attending ongoing training sessions, etc.

25. Attends and participates in educational programs, in-service meetings, workshops, and other activities as related to job knowledge and state guidelines.

26. Ability to work with minimum supervision and in a team environment.

27. Performs other job-related duties and assignments as requested/directed.

28. Demonstrates the ability to adjust to unexpected changes to assure all responsibilities/duties are met during absences or increases in work volume.

Qualifications

• Associate Degree strongly preferred, High School diploma or GED required

• Minimum of one (1) year experience in a large hospital’s Revenue Cycle Department with an emphasis on Patient Access and or Scheduling is strongly desired.

• Experience with large hospital information systems is required, preferably Epic and/or Siemens is preferred.

• Excellent interpersonal, problem solving and critical thinking skills

• Excellent PC skills with a strong emphasis on the Outlook suite of products

• Excellent verbal and written communication skills are required.

• Medical Terminology knowledge preferred

• Experience utilizing insurance payer websites preferred.

Schedule Details : 40 Hours Per Week, Mon-Fri, 8a-4p, 8:30a-4:30p, No Weekends and No Holidays. Remote/hybrid optional.

Primary Location

Massachusetts-Hyannis

Annual/Hourly : Hourly

Hiring Pay Range : $ 22.5 - $ 29.75

Thepayrange displayed on each job posting reflects the anticipated range for new hires. A successful candidate’s actual compensation will be determined after taking factors into consideration such as the candidate’s work history, experience, skill set, and education. This is not inclusive of the value of Cape Cod Healthcare’s benefits package (if applicable), which includes among other benefits, healthcare/dental/vision and retirement. For annual salaries this is based on full-time employment.