What you will do The following are essential tasks of the Rep III (Senior Analyst) position. Daily job duties are not limited to the list below. Ability to create projects in Government Reimbursement Manager™
Utilize MAC portals to complete MBI lookups
Run projects in Revenue Prospect Manager™ and produce results once complete.
Capability to review return results to ensure project ran successful through HETS and CWF
Recognize discrepancies between current project and previous projects and alert Lead for further investigation
Identify accounts in Government Reimbursement Manager™ that need calls and research completed
Make IVR calls on potential reimbursable claims Calls to MAC’s and review in Medicare portals
Calls to Home Health Agencies and Skilled Nursing Facilities
Review of external medical records and resources to identify a transfer, and receiving facility information
Rebill accounts through Medicare portal as well as monitor for claims that have been returned or rejected to guarantee prompt correction and resolution
Complete payment scrape to identify corrected claims that have paid additional reimbursement.
Execute existing SQL queries to create monthly logs for Medicare Advantage patients
Use CMS tools to complete estimated additional reimbursements for eligible claims
Establish and maintain login credentials for Medicare systems used by colleagues
Other duties as assigned What you will bring Bachelor's degree
Intermediate Microsoft Suite skills (Ex: Excel and SQL)
Strong analytical skills and ability to multi-task with attention to detail and accuracy Ability to interact effectively with peers, management and customers
Proficient in communication, research and critical thinking Ability to manage tasks independently, work quickly, take ownership of responsibilities and meet deadlines
Highly comfortable in a team setting
Process driven, yet adaptable to change when necessary
Experience working multiple projects at once Excellent organizational skills What we would like to see Experience with Epic, Meditech, McKesson or Cerner EHRs and/or exposure to Healthcare Information
Technology is a plus 1-2 years’ experience in Healthcare Revenue Cycle Management.
2+ years of experience in a healthcare related field
Background in Medicare claims Experience standardizing and validating large data sets Ability to collect, organize, analyze, and disseminate significant amounts of information