Health Business Solutions LLC

Claims Analyst

JOB OVERVIEW:

Under the direct supervision of the Project Director/Revenue Cycle Director, the position is responsible for the reporting and analysis of assigned RCM account data. This role involves developing reports, performing analysis and identifying opportunities in the revenue cycle process.

JOB DUTIES:

• Monitor and trend medical revenue cycle and business data for assigned accounts.
• Direct offshore team members on account priorities and workflow.
• Assist with complex projects regarding payer issues as needed.
• Attend and contribute in business/account meetings.
• Provide consistent reporting, analysis, and trending.
• Create and distribute assigned weekly, monthly, and quarterly Management reports for RCM.
• Provide Auditing data with documentation if necessary.
• Ad-hoc reporting and analysis for management team as requested.
• Analyze A/R, collection, reimbursement trends and RCM performance.
• Provide feedback to RCM leadership as assigned.
• Identification of root causes obtained through analysis and communication of findings
• Create, maintain and distribute monthly staffing matrices to RCM leadership to determine necessary staffing to support operations.
• Monitor and respond on a timely basis to report requests.
• Performs other job-related duties within the job scope as requested by CEO.
• Maintain strict confidentiality in accordance with HIPAA regulations and company policy.
• Conducts all business in a professional manner maintaining respect for individuals at all times.
• Researching, reviewing and adhering to all federal, state and local regulatory collection guidelines, as well as payer specific billing/collection guidelines.
• Provide technical assistance to co-workers and/or clients as requested, including providing assistance/instruction to achieve task completion. 
• Provide customer service, including timely response to telephone calls, e-mails, and other verbal or written correspondence.  Resolve client complaints to satisfaction.
• Participate in special projects or other responsibilities as needed or assigned.
•  Follows HBS rules, policies, procedures, applicable laws and standards.
• Carries out the mission, vision, values and quality commitment of HBS.
• Practice HIPAA compliance.