Reston Hospital · 1 day ago
Senior Insurance Collections Operations Analyst
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Responsibilities
Resolve claim processing delays from various payer products including HMO, PPO, Medicaid, Medicare, Auto and Workers’ Compensation.
Effectively utilize ERA payment information to identify trends and make recommendations.
Be able to utilize various data sources to drive decisions
Identify contract protection that can be leveraged when disputing delays in payment.
Work with vendors and other organizations when needed to resolve open accounts receivable
Articulate any payment delays to representatives from healthcare payer companies and government agencies.
Contact payer companies via phone or correspondence and initiates request for payment.
Escalate Payer lack of response and/or lack of payment within Payer organization as appropriate.
Overcome objections that prevent payment of the claim and gain commitment for payment through concise and effective argument.
Identify problem accounts/processes/trends and escalate as appropriate.
Utilize effective documentation standards that support a strong historical record of actions taken on the account.
Identifies Payer trends and communicates trends to supervisor for further action/escalation.
Qualification
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Required
Bachelor’s Degree in Business or related field required. Relevant work experience may substitute degree requirements.
Must have experience using SQL.
Strong excel experience required. Must be able to pull data and analyze.
Preferred
Two years of related experience preferred.
Benefits
Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.
Free counseling services and resources for emotional, physical and financial wellbeing
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)
Employee Stock Purchase Plan with 10% off HCA Healthcare stock
Family support through fertility and family building benefits with Progyny and adoption assistance.
Referral services for child, elder and pet care, home and auto repair, event planning and more
Consumer discounts through Abenity and Consumer Discounts
Retirement readiness, rollover assistance services and preferred banking partnerships
Education assistance (tuition, student loan, certification support, dependent scholarships)
Colleague recognition program
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.
Company
Reston Hospital
Welcome to Reston Hospital Center, a full-service, 231-bed acute care medical and surgical hospital serving residents in Reston and the growing Northern Virginia region.