Hospital Claims Analyst

Job description

Description JOB SUMMARY: Under the general direction of the Director of Business Services, the Hospital Claims Analyst will perform accurate/timely filing of initial insurance claims and secondary claims, follow up of claims not paid to assure payment to hospital and/or affiliated entities to maintain adequate cash flow and accounts receivable balance, in accordance with TJC, federal, state, and local guidelines, organizational and departmental policies and procedures. Communicates with medical staff, other departments, and outside agencies while maintaining confidentiality. Position requires self-motivation, creativity, and capabilities to function in a semi-autonomous role within a fast pace and dynamic environment. Hours: M-F, 8:30am - 5:00pm: STANDARDS OF PERFORMANCE: - Processes and adjust inpatient and outpatient medical claims in a timely fashion according to departmental quality and production standards. - Assists Director of Business Services in researching and determining status of medical claims to assure billed dollars, claims aging, and pend values are consistent with contract provisions. - Performs follow up and takes necessary actions required to resolve all errors a...