Insurance Recovery Analyst

Location: Norwood

Insurance Recovery Analysts are medical billers that are responsible for processing commercial, governmental and/or third-party liability (workmans compensation, general liability, and motor vehicle liability) medical claims. This position ensures that Claim Assists clients (hospitals) recover the maximum allowable medical fees in the most timely, efficient, and confidential manner.

ESSENTIAL FUNCTIONS:

Investigates, negotiates, bills and follows-up for payment regarding first and third-party claims involving any and all coverages, liability, and legal issues.

Identifies viable payers, obtains IBs, UBs, HCFAs, correspondence, and medical records when necessary.

Maintains the highest level of privacy in accordance with HIPAA requirements and laws.

Works their inventory by route while maintaining an acceptable level of aged accounts receivable.

Contacts patients, payers, hospitals, attorneys, employers, and any other parties involved to collect the necessary information and ensure reimbursement for our client.

Recovers maximum dollars for the hospital through coordination of benefits in a timely manner.

Appeals claims when applicable.

Meets monthly company, team, and individual goals, and all deadlines set by the Team Lead and Manager, Operations.

Completes special projects, as requested.

QUALIFICATIONS:

Minimum of four (4) years of directly related industry experience.

Emdeon/Change Healthcare billing experience is a plus.

EPIC, CERNER and/or MEDITECH experience is a plus.

Experience working claims in multiple states is a plus.

Strong technical knowledge in one or more areas of commercial insurance, government insurance, workmans compensation, motor vehicle liability, general liability and claims processing systems.

Knowledge of medical and insurance terminology.

Knowledge of coordination of benefits.

Working knowledge of FACS (Claim Assists host system) or comparable management software system.

Ability to speak confidently over the phone

Basic knowledge of Microsoft Excel and Word.

Ability to provide quality customer service to all parties.

Ability to work in a fast-paced environment

Demonstrated knowledge of state laws and insurance statutes.

Excellent interpersonal and verbal/written communications skills.

Highly motivated, self-starter, organized and detail-oriented.

Ability to work well individually, as well as part of a team.

Coachable: receptive to feedback, willing to learn, embraces continuous improvement, and responsive to change.

Ability to maintain a predictable and consistent full-time work schedule.

EDUCATIONAL REQUIREMENTS:

Bachelors degree in business or related field.

Insurance Institute Certificate(s) highly desirable.

Five (5) years of directly related experience in lieu of degree.

The CCS Companies is an Equal Opportunity Employer This document is considered CCS Proprietary and Confidential.