Priority Claims Analyst II

Hanger; United States; Remote; USD 60,000 - 80,000; Full time

Job summary

An established industry player is seeking a motivated Priority Claims Analyst II for a remote position. This role is pivotal in ensuring compliance and resolving issues related to EDI enrollment processes. The ideal candidate will have strong analytical and problem-solving skills, with a focus on maintaining exceptional support and communication with clinics and management. You will work collaboratively with an offshore team and manage various projects, making a significant impact on the patient care experience. If you're detail-oriented and proactive, this opportunity is perfect for you to grow and innovate in a supportive environment.

Qualifications

• Bachelor’s degree required; 4 years of experience in lieu of education acceptable.
• 3 years of experience in Hanger Clinic or related payor understanding preferred.

Responsibilities

• Maintain relationships with clients and ensure compliance with enrollment processes.
• Research and resolve internal enrollment issues and manage provider portal logins.

Skills

Analytical Skills

Problem-Solving Skills

Communication Skills

Detail-Oriented

Self-Starter

Education

Bachelor’s Degree

Tools

Excel

SharePoint

Microsoft Teams

Job description

Why Us?

With a mantra of Empowering Human Potential, Hanger, Inc. is the world's premier provider of orthotic and prosthetic (O&P) services and products, offering the most advanced O&P solutions, clinically differentiated programs and unsurpassed customer service. Hanger's Patient Care segment is the largest owner and operator of O&P patient care clinics nationwide. Through its Products & Services segment, Hanger distributes branded and private label O&P devices, products and components, and provides rehabilitative solutions to the broader market. With 160 years of clinical excellence and innovation, Hanger's vision is to lead the orthotic and prosthetic markets by providing superior patient care, outcomes, services and value. Collectively, Hanger employees touch thousands of lives each day, helping people achieve new levels of mobility and freedom.

Could This Be For You?

We are seeking to hire a Priority Claims Analyst II - Remote. Primary responsibilities include EDI enrollment processes, analysis, and resolution of issues. Ensure compliance, improve performance, as well as maintaining exceptional support and communication with clinics, employees, and management. Support of offshore Team. Other responsibilities may include liaison roles, payor portal set up, payor research and various other types of processing.

Your Impact

Principal Duties and Responsibilities (Essential Functions):

• Maintain positive relationships with internal and external clients in a professional and service-oriented manner.
• Proactively review and monitor changes/updates in enrollment paperwork and payer statuses. Interpret relevant data and decide on appropriate course of action.
• Responsible for researching, documenting and creating the user logins for provider portals.
• Responsible for resolution of internal enrollment issues initiated from clinics; either independently or through interaction with other internal departments.
• Develop and manage relationships with colleagues in a professional manner.
• Attend department meetings (video/audio) and discuss research and payor findings.
• Responsible for conducting special projects.

Knowledge and Skill:

• Computer skills essential; prefer experience with Excel, SharePoint and Teams.
• Motivated, proactive, research and detail oriented. Strong analytic and problem-solving skills.
• Ability to work independently. Self-starter and take the initiative to proactively solve/investigate problem areas.
• Ability to work collaboratively with other Team members. Discuss research and findings. Assist with integrating all into a process plan.
• Experience with Hanger Inc preferred or essential understanding and working knowledge of any of the following entities - Change Healthcare, Waystar, Availity.
• Ability to manage and complete multiple projects and activities with time-sensitive deadlines. Ability to multi-task.
• Able to communicate well and exhibit good interpersonal skills.
• Personal accountability and able to meet deadlines.
• Demonstrates high ethical standards regarding confidential patient and billing information, ensuring compliance with relevant laws, security protocols, including HIPAA requirements, regulations and established Hanger policies and procedures.
• Always act with integrity in all ways and remaining honest, transparent, and respectful in all relationships.
• Foster open collaboration and constructive dialogue with everyone around you.
• Continuously innovate new solutions, influencing and responding to change.
• Focus on superior outcomes and calibrate work processes for outstanding results.

Job Complexity:

• Works on problems of moderate scope where analysis of situations or data requires a review of a variety of factors. Exercises judgment within defined procedures and practices to determine appropriate action. Builds productive internal/external working relationships.

Supervision Received and Exercised:

• Normally receives general instructions on routine work, detailed instructions on new projects or assignments.

Minimum Qualifications

Experience and Education:

• Bachelor’s degree is required; 4 years of practical experience in lieu of education is acceptable.
• Typically requires 3 years of experience to include at least one of the following areas: Hanger Clinic, RCM or related payor understanding.

Environmental Factors:

Work environment characteristics, and physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Additional Success Factors

• Act with integrity in all ways and at all times, remaining honest, transparent, and respectful in all relationships.
• Keep the patient at the center of everything that you do, building lifelong trust.
• Foster open collaboration and constructive dialogue with everyone around you.
• Continuously innovate new solutions, influencing and responding to change.
• Focus on superior outcomes, and calibrate work processes for outstanding results.