Payer Customer Analyst II

This is a remote position in which we are able to employ in the following states: Alabama, Arizona, Arkansas, Connecticut, Florida, Georgia, Idaho, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maryland, Michigan, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Mexico, North Carolina, Oklahoma, Oregon, Pennsylvania, South Carolina, South Dakota, Tennessee, Texas, Utah, Virginia, West Virginia, or Wisconsin

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JOB SUMMARY/PURPOSE

• Secures payment by working closely with Payer and customer, ensuring authorization, notification, and point of service collection requirements are completed in a timely manner. Interacts with insurance companies, departments and service areas, physicians, utilization review, and customers to guarantee the accuracy and completeness of each account to maximize reimbursement. Serves as a resource for staff as needed.

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DEPARTMENT DESCRIPTION

• The Financial Clearance department is responsible for Insurance Verification and Preadmissions. Financial Clearance functions include insurance verification, authorization, collection and documentation of patient demographics, benefit analysis, estimates, financial counseling, and pre-service collections.

• EXPERIENCE/EDUCATION/QUALIFICATIONS

• High school diploma or equivalent required.

• Two (2) years collections, finance/accounting, medical billing or patient registration experience required.

• One (1) year experience equivalent to a SHS Payer Customer Analyst I role required.

• Experience or training in computer applications required.

• Experience or training in medical terminology, insurance authorization, reimbursement requirements and CPT/ICD-9 coding preferred.

• KNOWLEDGE/SKILLS/ABILITIES

• Confidentiality: Knowledge of the importance of confidentiality.

• Communication: Communicate information verbally and in writing so others will understand.

• Customer Service: Ability to communicate to people internal and external to the organization and to represent the organization to customers, the public and external sources.

• Problem Solving: Ability to identify problems and review related information using logic and reasoning to evaluate options and implement solutions.

• Team Building: Ability to work as part of a team or on your own.

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PHYSICAL DEMANDS

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Rarely

(1 - 10% of the time)

Occasionally

(11 - 33% of the time)

Frequently

(34 - 66% of the time)

Continually

(67 – 100% of the time)

WALK - INCLINE

CLIMB - STAIRS

LIFT (Floor to Waist: 0"-36") 20 - 40 Lbs

LIFT (Knee to chest: 24"-54") 0 - 20 Lbs

CARRY 1-handed, 0 - 20 pounds

CARRY 2-handed, 0 - 20 pounds

SQUAT Static (hold >30 sec)

SQUAT Repetitive

KNEEL (on knees)

PUSH (0-20 pounds force)

PULL (0-20 pounds force)

STAND

WALK - LEVEL SURFACE

LIFT (Waist to Eye: up to 54") 0 - 20 Lbs

LIFT (Overhead: 54" and above) 0 - 20 Lbs

BEND FORWARD at waist

LIFT (Floor to Waist: 0"-36") 0 - 20 Lbs

ROTATE TRUNK Sitting

ROTATE TRUNK Standing

REACH - Forward

REACH - Upward

PINCH Fingers

GRASP Hand/Fist

SIT

MANUAL DEXTERITY Hands/wrists

FINGER DEXTERITY