Medical Claims Analyst - AR Academy

Experience these exceptional benefits when you join Med-Metrix!

• 8-Hour Shifts
• Day 1 HMO with 2 of your dependents covered for FREE
• Group Life Insurance
• Medical Cash Allowance
• Rice Allowance
• Clothing Allowance
• Holiday Gift
• Bereavement Assistance
• Paid Time Off
• Training and Staff Development
• Employee Engagement Activities
• Opportunities for Internal Mobility
  
  

• Follow-up with payers to ensure timely resolution of all outstanding claims, via phone, emails, fax or websites
• Meets and maintains daily productivity/quality standards established in departmental policies
• Uses the workflow system, client host system and other tools available to them to collect payments and resolve accounts
• Adheres to the policies and procedures established for the client/team
• Knowledge of timely filing deadlines for each designated payer
• Performs research regarding payer specific billing guidelines as needed
• Ability to analyze, identify and resolve issues causing payer payment delays
• Ability to analyze, identify and trend claims issues to proactively reduce denials
• Communicates to management any issues and/or trends identified
• Initiate appeals when necessary
• Ability to identify and correct medical billing errors
• Send appropriate appeals, accurate requesting information, supporting documentation, and effective communication to complete recovery process
• Understanding of under or over payments and credit balance processes
• Assist with special A/R projects as needed. Analytical skills and the ability to communicate results are required
• Act cooperatively and courteously with patients, visitors, co-workers, management and clients
• Work independently from assigned work queues
• Maintain confidentiality at all times
• Maintain a professional attitude
• Other duties as assigned by the management team
• Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
• Understand and comply with Information Security and HIPAA policies and procedures at all times
• Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
  
  

• Completed any Bachelors Degree
• Fresh graduates or minimum of 6 months BPO experience, required.
• Must have no healthcare experience in the same capacity.
• Strong interpersonal skills, ability to communicate well at all levels of the organization
• Strong problem solving and creative skills and the ability to exercise sound judgment and make decisions based on accurate and timely analyses
• High level of integrity and dependability with a strong sense of urgency and results oriented
• Excellent written and verbal communication skills required
• Gracious and welcoming personality for customer service interaction
  
  

• Work Set-Up: Onsite
• Work Schedule: The role requires predominantly day shift work, with flexibility to adjust to other schedule assignments as needed.
• Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear.
• Mental Demands: The employee must be able to follow directions, collaborate with others, and handle stress.
• Work Environment: The noise level in the work environment is usually minimal.