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Performant Healthcare, Inc. · 2 days ago

Healthcare Billing Recovery Analyst

United States

Full-time

Remote

Mid Level

$23/hr - $23/hr

3+ years exp

Performant Healthcare, Inc. is a leading healthcare intelligence company that delivers value and efficiency to health plans. The Healthcare Billing Recovery Analyst will manage a provider portfolio focusing on recovery efforts, leveraging knowledge in Medicare and Medicaid, and resolving medical billing issues.

AnalyticsCustomer ServiceFinancial Services

Responsibilities

Engage in Outbound recovery calls, to Healthcare Carriers and Providers regarding improperly paid claims

Decision Support- Ability to accurately review supporting documentation provided to Performant, by Providers/Carriers to determine accuracy of finding or overpayment allegation, for Complex appeals and disputes

Maintain current knowledge in Medicare and Medicaid practices and regulatory issues that may affect our clients

Leverage your knowledge and expertise to research Overpayments and answer questions and/or provide information that will bring to successful resolution and payment

Educate Healthcare providers/carriers on their obligation to pay

Ability to analyze and understand written communication from insurance companies including explanation of benefits

Support internal groups or functions with gathering and interpretation of the billing and collections work to development with knowledge base and understanding of key concepts and terminology in healthcare billing and claims

Leverages existing excel skills to create Provider centric reporting on demand, or at Managements request

Effectively follow and contribute to continuous improvement of scripts, guidelines and other tools provided to have professional conversations with Healthcare Insurance providers

Efficiently and diligently work through assigned inventories to meet productivity metrics assigned by management

Ability to maintain and function in multiple client systems and environments at one time

Updates company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, payment commitments, as well as account status updates as applicable

Arrives to work on-time, works assigned schedule, and maintains regular attendance

Follows and complies with company and departmental policies, processes and procedures

Responsible for utilizing resources to ensure compliance with client requirements, HIPAA, as well as applicable federal or state regulations

Successfully completes, retains, applies and adheres to content in required training as assigned

Consistently achieve or exceed established metrics and goals assigned

Demonstrates Performant core values in performance of job duties and all interactions

Correct areas of deficiency and oversight received from quality reviews and/or management

Qualification

Healthcare BillingMedicare/Medicaid KnowledgeCoordination of BenefitsAnalytical SkillsExcel SkillsCommunication SkillsProblem SolvingAttention to Detail

Required

Bachelor's degree in relevant field or equivalent combination of education and experience. Significant experience along with a high school diploma, may also be considered in lieu of a completed degree

At least 3 years directly relevant professional working experience in a highly analytic or Recovery role

Experience in Healthcare Billing and/or Coding is required

Knowledge or experience with Healthcare, Coordination of benefits or Revenue cycle management, and the like

Ability to demonstrate, strong written and verbal communication skills

Basic understanding of revenue cycle management or Medical recovery

Strong knowledge and material experience with Healthcare, Medical terminology, Coding, Billing. Preferably a role in recovery or revenue cycle management

Demonstrates knowledge in post-payment recovery

Demonstrates the ability to solve complex Provider or Carrier billing questions, that assist in the resolution and understanding of the overpayment

Communicates effectively with Providers and Carriers to answer any questions and/or provide information that will bring successful payment or other resolution to the account

Demonstrated expertise in Medicare and Medicaid plans policy and procedure

Up to date knowledge in Medicare/Medicaid appeal processing

Knowledge in Coordination or benefits (COB)

Demonstrates a high degree of critical thinking and analytical accuracy required to be successful

Proven ability to gather and interpret explanation of benefits (EOB) and answer questions and resolve standard as well as complex issues with payments

Strong skills using standard office technology; Computer, various applications and navigation of on-line tools and resources

Intermediary to Advanced excel skills

Applies knowledge learned in training

Self-motivated and thrives in a fast-paced business operations department performing multiple tasks cohesively, with keen attention to detail

Must have the availability to communicate via phone with Providers and or Carriers in a quiet space 5+ hours daily