The SSI Group, LLC · 1 week ago
Insurance Analyst
The SSI Group, Inc., 4721 Morrison Drive, Mobile, Alabama, United States of America
Full-time
Onsite
Entry Level
2+ years expThe SSI Group, LLC, headquartered in Mobile, Alabama, is a national leader in Healthcare Technology. They are seeking an Insurance Analyst responsible for managing medical insurance claims, billing processes, and data entry to ensure accurate reimbursement and compliance with healthcare regulations.
ComputerHealth CareSoftware
Responsibilities
Process, review and submit insurance claims to third-party payers (Medicare, Medicaid, private insurers) based on medical coding, billing data, and patient insurance information
Ensure that claims are complete, accurate, and compliant with payer-specific rules and guidelines
Investigate and analyze denied claims, identifying the cause of denials (e.g., coding errors, missing documentation, eligibility issues)
Work with coding and clinical teams to resolve issues and resubmit claims for payment
Appeal denied claims and work to ensure that payments are received promptly
Review insurance company remittance advice (EOBs) to confirm payments are consistent with the terms of the payer contract
Resolve discrepancies between billed amounts and paid amounts, ensuring accurate adjustments and patient responsibility
Communicate with payers to resolve any outstanding payment issues
Ensure proper verification of patient insurance eligibility and benefits prior to service delivery
Confirm that required pre-authorizations or referrals are obtained for specific procedures, treatments, or hospital admissions
Track and report on key performance indicators (KPIs) related to claims processing, such as claim approval rates, denials, and aged accounts
Generate reports to identify trends in claims issues, payer performance, and payment delays
Post insurance and patient payments accurately into billing systems and reconcile transactions to ensure proper allocation
Stay up-to-date with changes in healthcare regulations, payer policies, and billing codes (ICD-10, CPT, HCPCS)
Ensure that the department remains compliant with federal, state, and payer-specific billing requirements, including HIPAA
Assist patients and other stakeholders with insurance-related inquiries, helping to explain coverage issues, billing questions, or denials
Qualification
Required
High school diploma or equivalent required
2+ years of experience with medical billing required
Experience in healthcare billing or revenue cycle management, with a solid understanding of insurance processes and claim handling
Strong analytical and problem-solving abilities
Knowledge of insurance terminology, healthcare regulations, and payer-specific guidelines
Familiarity with billing software and electronic health record (EHR) systems
Excellent communication skills, both written and verbal
Attention to detail and ability to prioritize tasks in a fast-paced environment
Proficiency with Microsoft Office suite
Must be able to see clearly with or without corrective lenses and hear clearly with or without aids
Must be able to use hands, fingers and wrists, repetitively, using a computer keyboard and other office equipment, regularly
Must be able to proficiently speak, read and write in English
Preferred
Associate's degree in Healthcare Administration, Business, or a related field preferred
Credentialing experience a plus
Benefits
Medical
Dental
Life/AD&D
LTD
Vision
401(k) matching
Paid vacation
Tuition reimbursement
Company
The SSI Group, LLC
A leading provider of revenue cycle management solutions, The SSI Group (SSI) partners with healthcare providers and payers.
201-500 employees
H1B Sponsorship
The SSI Group, LLC has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2023 (1)
2022 (2)
2020 (1)
Funding
Current Stage
Growth StageLeadership Team
Diana Allen
Chief Executive Officer
Recent News
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