Job Description

We are seeking a highly skilled Claims Analyst with expertise in Hospital Billing (HB), Claims, and Remittance (Remit) processes to join our team on a temp-to-perm basis. The successful candidate will play a critical role in ensuring accurate and timely claims processing, managing remittance workflows, and supporting the overall revenue cycle management. This role is remote and is ideally suited for a detail-oriented professional with relevant certifications in HB Administration, Claims, and Remits.

Key Responsibilities:

• Claims Analysis and Processing: Analyze, review, and process claims with a focus on accuracy and compliance with payer guidelines. Ensure all claims are filed and resolved in a timely manner to optimize revenue.
• Remittance Management: Handle all remittance-related activities, including posting, reconciliation, and troubleshooting any discrepancies with payers.
• Denial Resolution: Identify, analyze, and resolve claim denials by collaborating with billing, coding, and payer representatives to maximize claim reimbursements.
• Compliance and Documentation: Ensure compliance with healthcare regulations and payer policies. Maintain accurate documentation of all claims activities and remittance processes.
• Communication and Support: Provide clear and effective communication with internal and external stakeholders regarding claim status, remit postings, and payment issues. Work collaboratively to support cross-functional teams within the revenue cycle department.

Required Qualifications:

• Certifications: HB Administration, Claims, and Remits certifications required.
• Demonstrated experience in claims analysis, remittance processing, and revenue cycle management, specifically within hospital billing and claims.
• Proficiency with claims processing software and systems, along with strong skills in Microsoft Office Suite
• Ability to review and verify large volumes of claims data accurately.

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Job Tags

Permanent employment, Temporary work,

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