Claims Escalation Analyst - Lake Charles, United States - Lake Charles Memorial Health System

Lake Charles Memorial Health System
Lake Charles Memorial Health System
Verified Company
Lake Charles, United States

1 week ago

Mark Lane

Posted by:

Mark Lane

beBee recruiter
Full time
Description

DESCRIPTION OF POSITION:


RESPONSIBILITIES AND DUTIES:


  • Analyze and interpret policy language, contracts and statutes
  • Maintain accurate records of all claims and ensuring timely resolution
  • Understands assigned payer's allowable calculations in order to preview an account to determine if properly paid and identify when errors are made in payments.
  • Accurately posts transactions based on assigned duties ensuring that keying is correct for all payments, adjustments, deductibles & coinsurance assignments.
  • Able to evaluate transactions posted on an account to ensure all payments and adjustments are posted and are appropriate.
  • Works with other departments to resolve any outstanding issues delaying claims processing.
  • Communicates effectively with assigned payer and makes appropriate decisions to escalate and push claims with carriers, companies and other departments.
  • Accurately evaluates each account in order to determine what is needed, what is left outstanding and what steps are necessary to resolve the account quickly.
  • Properly utilizes productivity tracking mechanisms.
  • Works at or above the weekly set productivity standard and completes tasks in a timely manner.
  • Documents all information in the System following the Clear Concise Consistent method.
  • Consistently monitors assignment to ensure that all steps necessary to assist the Team with achieving its goals have been taken.
  • Able to write clearly and informatively

EDUCATION AND WORK EXPERIENCE

  • High school graduate or GED certificate, required.
  • Minimum of 1year experience in Healthcare, preferably in the insurance industry
  • Proficient in Microsoft Office suite
  • Analytical and problemsolving skills
  • Excellent communication and interpersonal skills
  • Ability to work well in a team environment
  • Adequate keyboarding skills (40 words per minute typing rate)
  • Strong organizational and communication skills, including ability to discuss medical issues.
  • Negotiation skills including assertiveness and being proactive.
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