Medical Billing Review Analyst
Company Name:
TalenTrust
COMPANY OVERVIEW
Our client (The Assist Group) is a leading provider of healthcare cost management solutions that specializes in prospective, catastrophic/high-dollar hospital bill review for all types of clinical conditions. Their operations, client services, account management and clinical teams manage the entire review, appeal and resolution process, from beginning to end, directly with the facilities. The company provides claims review, negotiation and resolution services and neonatal care management solutions to health plans, third party administrators (TPA's), managed care organizations, reinsurers and Managing General Underwriters (MGU's). The Assist Group was honored with Colorado Companies to Watch in 2011, and Denver Posts Top Workplaces in 2012.
POSITION SUMMARY
The Medical Billing Analyst is responsible for reviewing, analyzing, documenting, and creating Preliminary and Final reports within time and quality assurance standards.
The Medical Billing Analyst I is a critical training role. During the first 90 days, the Medical Billing Analyst will be learning and beginning to execute the essential functions as listed below. Following the initial 90 days of employment, the Medical Billing Analyst I will be evaluated for demonstration proficiency and professionalism. If the candidate has demonstrated the required criteria and skill set, this person will receive a promotion to Medical Billing Analyst II. Otherwise, a Performance Improvement Plan will be executed to develop individual performance.
PRINCIPAL DUTIES AND RESPONSIBILITIES
The Medical Billing Review Analyst I will be learning to perform the following functions:
Meet the requirements for promotion from Medical Billing Review Analyst I (e.g. punctuality, independent management of work queue)
Complete line-by-line analysis of hospital bills utilizing Excel and The Assist Groups internal software system for alignment with internal and external policies and produces
Apply judgment (in conjunction with review algorithms) to determine how to proceed with a claim
Collaborate with the Clinical team to apply review findings as line-item edits
Generate reporting and supporting documents for insurance companies and medical facilities to support line-item edit rationale
Identify and communicate the need for additional documents required to complete review and/or reporting
Perform self-quality checks on reports, including verification of formulas and adherence to internal and external policies and procedures
Assist the Resolution and Appeals department in creating additional reports and exhibits or making revisions to existing materials, as necessary
Work with other teams to meet shared goals
Manage personal claim work queue, prioritizing deadlines for claims at various phases
Maintain up-to-date documentation on all claims according to company standards
Meet time, quality, and customer satisfaction standards during preliminary and final review processes
Other
Access client portals to obtain ancillary claim review documentation
Test Hands improvements as necessary
Maintain HIPAA confidentiality and privacy standards when completing assigned work
Participate in department and company meetings as requested
Complete special projects as assigned
Interact with clients and consultants as requested
QUALIFICATIONS
Bachelors Degree preferred; Associates Degree or equivalent experience required
Medical bill coding certifications helpful
Experience
1-2 years professional work experience in data analysis/insurance claims review required
Familiarity with medical terminology preferred
Skills
Proven qualitative analysis and critical thinking skills
Advanced computer skills, specifically Excel
Strong arithmetical skills (e.g. percentages, multiple-step calculations)
Detail-orientated approach to work; focus on quality
Ability to independently manage, organize, and prioritize multiple tasks in a fast-paced production environment
Team player demonstrating enthusiasm and commitment to company vision and mission through collaboration and cooperation
Flexibility to adapt to a dynamic, evolving work environment
COMPENSATION:
A competitive salary is offered depending on experience. Excellent benefits plan details will be provided to final candidates.
ABOUT US
TalenTrust works with rapidly growing, middle market companies who value their people. We are our clients recruitment partner and identify exceptional talent to accelerate their growth. Unlike traditional staffing models, our recruitment process ensures full integration to capture a clients culture and employment brand. We provide a personalized and collaborative value proposition to both the candidate and client.
Find out more about us by visiting our website www.TalenTrust.com.
Keywords: Data Analytics, Data Analysis, Forensic Review, Analysis, Recent College Graduate, Lakewood, Denver, Colorado, Bachelors of Science in Business Administration, Math, Mathematics, Economics, Physics, Chemistry, Pharmacy, Pharmacy Technician, Medical Billing, Insurance, Detail Orientation, Problem Resolution, Excel, Medical Claims, Medical Coding, Medical Billing, Healthcare, Hospital Billing, Insurance Claims, Forensic AnalystEstimated Salary: $20 to $28 per hour based on qualifications.
TalenTrust
COMPANY OVERVIEW
Our client (The Assist Group) is a leading provider of healthcare cost management solutions that specializes in prospective, catastrophic/high-dollar hospital bill review for all types of clinical conditions. Their operations, client services, account management and clinical teams manage the entire review, appeal and resolution process, from beginning to end, directly with the facilities. The company provides claims review, negotiation and resolution services and neonatal care management solutions to health plans, third party administrators (TPA's), managed care organizations, reinsurers and Managing General Underwriters (MGU's). The Assist Group was honored with Colorado Companies to Watch in 2011, and Denver Posts Top Workplaces in 2012.
POSITION SUMMARY
The Medical Billing Analyst is responsible for reviewing, analyzing, documenting, and creating Preliminary and Final reports within time and quality assurance standards.
The Medical Billing Analyst I is a critical training role. During the first 90 days, the Medical Billing Analyst will be learning and beginning to execute the essential functions as listed below. Following the initial 90 days of employment, the Medical Billing Analyst I will be evaluated for demonstration proficiency and professionalism. If the candidate has demonstrated the required criteria and skill set, this person will receive a promotion to Medical Billing Analyst II. Otherwise, a Performance Improvement Plan will be executed to develop individual performance.
PRINCIPAL DUTIES AND RESPONSIBILITIES
The Medical Billing Review Analyst I will be learning to perform the following functions:
Meet the requirements for promotion from Medical Billing Review Analyst I (e.g. punctuality, independent management of work queue)
Complete line-by-line analysis of hospital bills utilizing Excel and The Assist Groups internal software system for alignment with internal and external policies and produces
Apply judgment (in conjunction with review algorithms) to determine how to proceed with a claim
Collaborate with the Clinical team to apply review findings as line-item edits
Generate reporting and supporting documents for insurance companies and medical facilities to support line-item edit rationale
Identify and communicate the need for additional documents required to complete review and/or reporting
Perform self-quality checks on reports, including verification of formulas and adherence to internal and external policies and procedures
Assist the Resolution and Appeals department in creating additional reports and exhibits or making revisions to existing materials, as necessary
Work with other teams to meet shared goals
Manage personal claim work queue, prioritizing deadlines for claims at various phases
Maintain up-to-date documentation on all claims according to company standards
Meet time, quality, and customer satisfaction standards during preliminary and final review processes
Other
Access client portals to obtain ancillary claim review documentation
Test Hands improvements as necessary
Maintain HIPAA confidentiality and privacy standards when completing assigned work
Participate in department and company meetings as requested
Complete special projects as assigned
Interact with clients and consultants as requested
QUALIFICATIONS
Bachelors Degree preferred; Associates Degree or equivalent experience required
Medical bill coding certifications helpful
Experience
1-2 years professional work experience in data analysis/insurance claims review required
Familiarity with medical terminology preferred
Skills
Proven qualitative analysis and critical thinking skills
Advanced computer skills, specifically Excel
Strong arithmetical skills (e.g. percentages, multiple-step calculations)
Detail-orientated approach to work; focus on quality
Ability to independently manage, organize, and prioritize multiple tasks in a fast-paced production environment
Team player demonstrating enthusiasm and commitment to company vision and mission through collaboration and cooperation
Flexibility to adapt to a dynamic, evolving work environment
COMPENSATION:
A competitive salary is offered depending on experience. Excellent benefits plan details will be provided to final candidates.
ABOUT US
TalenTrust works with rapidly growing, middle market companies who value their people. We are our clients recruitment partner and identify exceptional talent to accelerate their growth. Unlike traditional staffing models, our recruitment process ensures full integration to capture a clients culture and employment brand. We provide a personalized and collaborative value proposition to both the candidate and client.
Find out more about us by visiting our website www.TalenTrust.com.
Keywords: Data Analytics, Data Analysis, Forensic Review, Analysis, Recent College Graduate, Lakewood, Denver, Colorado, Bachelors of Science in Business Administration, Math, Mathematics, Economics, Physics, Chemistry, Pharmacy, Pharmacy Technician, Medical Billing, Insurance, Detail Orientation, Problem Resolution, Excel, Medical Claims, Medical Coding, Medical Billing, Healthcare, Hospital Billing, Insurance Claims, Forensic AnalystEstimated Salary: $20 to $28 per hour based on qualifications.
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