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The CCS Companies · 3 days ago

Insurance Recovery Analyst

Norwood, MA

Full-time

Onsite

Mid, Senior Level

4+ years exp

The CCS Companies is seeking an Insurance Recovery Analyst to manage and process medical claims for their clients. The role involves investigating and negotiating claims to ensure maximum recovery of medical fees while adhering to HIPAA regulations.

Financial ServicesInformation TechnologyMessaging

Responsibilities

Investigates, negotiates, bills and follows-up for payment regarding first and third-party claims involving any and all coverages, liability, and legal issues

Identifies viable payers, obtains IBs, UBs, HCFAs, correspondence, and medical records when necessary

Maintains the highest level of privacy in accordance with HIPAA requirements and laws

Works their inventory by route while maintaining an acceptable level of aged accounts receivable

Contacts patients, payers, hospitals, attorneys, employers, and any other parties involved to collect the necessary information and ensure reimbursement for our client

Recovers maximum dollars for the hospital through coordination of benefits in a timely manner

Appeals claims when applicable

Meets monthly company, team, and individual goals, and all deadlines set by the Team Lead and Manager, Operations

Completes special projects, as requested

Qualification

Claims processing systemsCommercial insurance knowledgeGovernment insurance knowledgeEmdeon/ChangeHealthcare experienceEPIC/CERNER/MEDITECH experienceCoordination of benefitsFACS management softwareMedical terminologyMicrosoft ExcelMicrosoft WordCustomer serviceInterpersonal skillsVerbal/written communicationTeamworkAdaptability

Required

Minimum of four (4) years of directly related industry experience

Strong technical knowledge in one or more areas of commercial insurance, government insurance, workmans compensation, motor vehicle liability, general liability and claims processing systems

Knowledge of medical and insurance terminology

Knowledge of coordination of benefits

Working knowledge of FACS (ClaimAssists host system) or comparable management software system

Ability to speak confidently over the phone

Basic knowledge of Microsoft Excel and Word

Ability to provide quality customer service to all parties

Ability to work in a fast-paced environment

Demonstrated knowledge of state laws and insurance statutes

Excellent interpersonal and verbal/written communications skills

Highly motivated, self-starter, organized and detail-oriented

Ability to work well individually, as well as part of a team

Coachable: receptive to feedback, willing to learn, embraces continuous improvement, and responsive to change