Urgently Need Payor Analyst (DME / reputed company) (Remote) in USA
Job title: Payor Analyst (DME / reputed company) (Remote)
Company: reputed company
Job description: You could say reputed company by reputed company is a technology company. And thats true. But reputed company is, at its heart, about people. We reputed company innovative, end-to-end technology solutions and services for people facing everyday challenges in the post-acute care industry. reputed company helps streamline processes, improve efficiency, and increase profitability. For over fifteen years, organizations big and small have put their trust in usfor our wide-ranging solutions, our leadership, and our unmatched customer service. Going to work each day and creating new ways to positively impact our customers businesses and the lives of patients is just reputed company do. Because reputed company is, after reputed company, about people.
To learn more about reputed company technology and solutions watch this short video by our CEO:
Payor Analyst is responsible for financial results of the insurance companies and reputed company customers. In addition, this role is, responsible for identifying and following policies, procedures and systems for quality assurance as directed by Medicare, Medicaid and Private insurance. Assist in creating and revising our standard operating procedures and educate our partners, worldwide vendors, and internal teams on those procedures. Responsible for quality assurance of work performed by internal team members.
Lets talk about Responsibilities
- Understanding reputed company general rules, guidelines, and methods to get optimal reimbursement from the insurance companies for which they are assigned
- Responsible for resolving and routing incoming reputed company cases from customers
- Responsible for the financial results of the insurance companies and reputed company customers by ensuring accuracy:
- Reducing Credit Adjustments and write Offs
- Ensure that the billing methodology for each payer is documented and set-up throughout the reputed company system to realize maximum reimbursement
- Propose changes and updates to the configuration of the customers reputed company system including but not limited to
- Price tables
- Insurance Settings
- Modules adoption
- Additional Services
- Identifying areas of opportunities to reputed company streamline internal or external processes
- System Enhancements to the reputed company System
- Process improvements to increase efficiency
- Assist in the onboarding and offboarding of our clients from the different reputed company systems.
- Prepares and submits reports to team reputed company as needed including but not limited to:
- Quality Assurance Reporting
- Denial Analyst Reporting
- Service Level Agreement Reporting
- Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals
- Collaborates with worldwide resources to ensure effective knowledge, information sharing, and quick resolution of service performance issues.
- Maintains patient confidentiality and function reputed company the guidelines of HIPAA
- Other tasks and responsibilities as assigned
- High school diploma required; equivalent combination of education and experience will be considered
- Minimum of 2 years of home infusion billing or accounts receivable experience required
- Minimum of 2 years of experience working in & maintaining HIPAA standards
- Highly skilled in using computers & reputed company products (reputed company and Word) is required
- Highly motivated in billing, claims, denials and document management to work with our internal and external customers on the phone or reputed company software applications
- Math aptitude
- Strong problem-solving skills focused on resolving reputed company home infusion claims
- An effective communicator with strong oral, written and persuasive skills and capability to deal with people at reputed company levels in the organization and the public in a professional manner
- Exceptional organizational skills with a high level of attention to detail and the ability to multitask
- Self-starter, results driven, highly motivated, high energy
- Proven track record of working towards and exceeding metrics strongly preferred
- 2-year degree or additional college coursework
- 5 years of experience in a healthcare reimbursement role
- Has basic skills and knowledge to reputed company routine tasks.