Payor Analyst jobs in United States
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US Digestive Health · 17 hours ago

Payor Analyst

US Digestive Health is seeking a Payor Analyst responsible for completing complex appeals, refund audits, and payor projects. The role involves resolving denied claims, maintaining documentation, and participating in departmental communication.

Health Care

Responsibilities

Assist in resolving denied, scrubbed, or held claims by investigating rejected claims, utilizing provider websites or phone conversations to determine corrective actions
Maintain appropriate documentation and files regarding all patient account interactions in the Revenue Cycle Management System
Field questions from co-workers and staff as required
Actively participate in facility and departmental communication through daily review of email messages
Review claim documentation and correct coding when necessary
Recognize and research trending claim denials
Stay updated on specific billing requirements to ensure appropriate claims processing and reimbursement
Perform any other duties as assigned by the manager

Qualification

CPT/ICD10/HCPCS knowledgeEMR systems experienceClaims processingData entryPeople skillsInsurance guidelines knowledgeOrganizational skills

Required

High School Diploma or GED Equivalent
Minimum of 2-3 years of experience in a medical or office setting
Must be authorized to work in the US for any employer

Preferred

Experience with EMR systems

Company

US Digestive Health

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US Digestive Health is a network of gastroenterology practices focused on helping patients.

Funding

Current Stage
Late Stage

Leadership Team

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Mark Johnston
Partner Regional Gastroenterology Inc.
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Melissa DiGiacomo
Human Resources Business Partner
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Company data provided by crunchbase