Financial Claims Analyst Representative
- High School diploma or GED required; Associates degree preferred.
- Two (2) years of experience with claims processing and procedures required.
- Independent Health claims experience preferred to include experience with current operating systems. Understanding in CPT and IDC-9 coding with strong knowledge of billing preferred.
- Ability to grasp new processes and procedures.
- Decision making and analytical skills for review of health care benefits as they relate to payments.
- Excellent written and verbal communication skills.
- PC and Windows skills required, Siebel and Maccess preferred.
- Proven examples of displaying the IH values: Passionate, Caring, Respectful, Trustworthy, Collaborative, and Accountable. Essential Accountabilities Technical Proficiency:
- Ensure that all voids and cash adjustments are logged, researched, adjusted, reprocessed, and recorded to the operations and financial systems in an accurate, consistent, and timely manner. Coordinate with provider offices and internal departments when necessary. Account for all refund cash that is received by Independent Health monthly.
- Maintain technical proficiency by developing/updating the departmental policy and procedure manual on a regular basis and keeping up with any new workflow processes.
- Summarize all activity monthly for review by the accounting, COB, and internal operations departments. Recommend areas for improvement to specific departments based on these findings.
- Ensure accuracy of invoices received from third party collection agencies on workers compensation cases. Review and validate all listed claims where reimbursement is requested. Notify internal departments of any necessary adjustments.
- Assist in the cross training of other department members as it relates to cash adjustments.
- Lend support to accounts receivable department to expedite the collection process as needed.
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