Insurance Recovery Analyst

POSITION SUMMARY:  Insurance Recovery Analysts will be responsible for processing Workman’s Compensation, General Liability, and/or Motor Vehicle Liability hospital insurance claims.  Insure the client (Hospital) recovers the maximum allowable medical fees in the most timely, efficient, and confidential manner.

 

ESSENTIAL FUNCTIONS:

·  Investigate and negotiate payment for first and third party claims involving any and all coverage’s, liability, and legal issues.  Identify viable payers, obtain IBs, UB92s, 1500s, correspondence, and Medical Records when necessary; while maintaining the highest level of privacy in accordance with HIPAA requirements and laws.

 

·  Responsible for working their inventory by route while maintaining an acceptable level of aged accounts receivable.

 

·  Must contact patients, payers, hospitals, attorneys, employers, and any other parties involved to collect the necessary information to insure reimbursement for our client.

 

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

 

·  Must meet monthly company goals, team goals, and individual goals as well as all deadlines set by the Director and Supervisor.

 

·  Complete special projects when requested

 

 

 

 

 

 

 

 

EXPERIENCE REQUIREMENTS

·  Strong technical knowledge in one or more areas of Workmen’s Compensation, Motor Vehicle Liability, General Liability and claims processing systems.

·  Knowledge of medical terminology.

·  Knowledge of insurance terminology.

·  Knowledge of coordination of benefits.

·  Working knowledge of FACS (our host system) or comparable management software system.

·  Basic knowledge of Excel and Word for Windows.

·  Provide quality customer service to all parties.

·  Must be able 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.

·  Work well individually as well as part of a team.

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EDUCATIONAL REQUIREMENTS

·  Bachelor’s/Associates degree preferred in Business or related field

·  Minimum of 2 years directly related industry experience.

·  Insurance Institute Certificate(s) highly desirable.

·  5 Years of Directly Related Experience in lieu of degree.