Physician Insurance Analyst 4
Job DescriptionAs a Physician Insurance Analyst 4 you will complete all assigned EPIC billing/claim edits and ensure all required reports are filed timely and accurately.
Identify opportunities for revenue cycle performance improvements and report to management team as it relates to assigned duties.
Identify and report trends, assist in the development and deployment of training relative to trends in conjunction with Team Lead, Supervisor, Manager or Director.
Other duties as assigned by Department Manager, Director or Senior Director.
Job Responsibilities Performs the duties for a Physician Insurance Analyst I, II and III and capable of providing training to new staff or deploying insurance updates to existing staff.
Responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims, while meeting the expected Productivity and Quality Standards on a weekly basis.
Processes claims for all payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.
) and process all types of EPIC charge review and claim edits.
Assure all assigned claims meet clearinghouse and/or payer processing criteria.
Processes Appeals (level 1 and 2) and check claim status via phone/payer website for all payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.
).
Identifies trends and analyzes data.
Payer response reports and rejection/denials reports are worked timely and meet Departmental Productivity and Quality Review Standards.
Effectively interprets CPT, ICD-10 and APC reimbursements to insure a strong receivable performance.
Assures appropriate and timely documentation of all account activity.
Ensures correspondence is handled appropriately.
Other duties as assigned.
Additional RequirementsEducation:
High School Education of GED
Experience:
3 years' experience in Revenue cycle operations, billing, collections, cash posting, and/or administrative support in physician billing.
Certification:
AAHAM CRCS-I or CRCS-P certification or required within one year of employment.
Skills:
-Keyboard and CRT skills-Proficient in Microsoft Office -Ability to work complex accounts with little to no supervision -Capable of the interpretation, completion, and successful follow through on all insurance denials.
-Working knowledge of Patient Accounting System(s).
About UsInova is Northern Virginia's leading nonprofit healthcare provider.
Our mission is to provide world-class healthcare - every time, every touch - to each person in every community we have the privilege to serve.
Inova's 18,000 team members serve more than 2 million individuals annually through an integrated network of hospitals, primary and specialty care practices, emergency and urgent care centers, outpatient services and destination institutes.
Recommended Skills Accounts Receivable Administration Billing Cash Management Claim Processing Computer Keyboards Estimated Salary: $20 to $28 per hour based on qualifications.
Identify opportunities for revenue cycle performance improvements and report to management team as it relates to assigned duties.
Identify and report trends, assist in the development and deployment of training relative to trends in conjunction with Team Lead, Supervisor, Manager or Director.
Other duties as assigned by Department Manager, Director or Senior Director.
Job Responsibilities Performs the duties for a Physician Insurance Analyst I, II and III and capable of providing training to new staff or deploying insurance updates to existing staff.
Responsible for the timely and accurate editing, submission, and/or follow-up of assigned claims, while meeting the expected Productivity and Quality Standards on a weekly basis.
Processes claims for all payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.
) and process all types of EPIC charge review and claim edits.
Assure all assigned claims meet clearinghouse and/or payer processing criteria.
Processes Appeals (level 1 and 2) and check claim status via phone/payer website for all payer types (Commercial, Managed Care, Blue Cross, Medicare, Medicaid, etc.
).
Identifies trends and analyzes data.
Payer response reports and rejection/denials reports are worked timely and meet Departmental Productivity and Quality Review Standards.
Effectively interprets CPT, ICD-10 and APC reimbursements to insure a strong receivable performance.
Assures appropriate and timely documentation of all account activity.
Ensures correspondence is handled appropriately.
Other duties as assigned.
Additional RequirementsEducation:
High School Education of GED
Experience:
3 years' experience in Revenue cycle operations, billing, collections, cash posting, and/or administrative support in physician billing.
Certification:
AAHAM CRCS-I or CRCS-P certification or required within one year of employment.
Skills:
-Keyboard and CRT skills-Proficient in Microsoft Office -Ability to work complex accounts with little to no supervision -Capable of the interpretation, completion, and successful follow through on all insurance denials.
-Working knowledge of Patient Accounting System(s).
About UsInova is Northern Virginia's leading nonprofit healthcare provider.
Our mission is to provide world-class healthcare - every time, every touch - to each person in every community we have the privilege to serve.
Inova's 18,000 team members serve more than 2 million individuals annually through an integrated network of hospitals, primary and specialty care practices, emergency and urgent care centers, outpatient services and destination institutes.
Recommended Skills Accounts Receivable Administration Billing Cash Management Claim Processing Computer Keyboards Estimated Salary: $20 to $28 per hour based on qualifications.
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