Submit Open Negotiation letters and IDR Disputes for federal and state processes
Analyze insurance cards and EOBs to determine if a claim is Self Funded or Fully Funded
Run reports to identify trends and patterns within claims inventory to drive workflow including any bulk account actions that can be applied to the inventory (Example: non-viable IDR submissions)
Manage relationships with Out of Network payers to establish a claim settlement process where applicable
Analyze data to identify areas for improvement within inventory for billing, claim reimbursement, and follow-up processes
Validate analytics using data from client systems
Review insurance companies payment patterns and denials to identify any trends and irregularities.
Reconcile inventory including payments, adjustments and returned accounts as needed
Present IDR findings in a clear and concise manner to clients and internal stakeholders
Work closely with product management and implementation teams regarding any new operational analytic enhancements which may be needed for one or many clients.

Bachelor's Degree or equivalent experience
3+ years of experience in hospital revenue cycle analytics preferred or equivalent experience in hospital accounts receivable claims management
Experience in reviewing insurance cards, EOBs, and claims data
Knowledge of Revenue Cycle and different Revenue Cycle systems/applications

Revenue Cycle Analyst

Key skills