Account Analyst
Description
Signature Health Inc. is a non-profit healthcare agency whose mission is to put good health within reach of all of our community members through comprehensive mental health, medical, and support services essential for optimizing the well-being of mind and body. Serving patients in Lake, Ashtabula and Cuyahoga counties, we are committed to increasing access to a continuum of care while integrating behavioral and physical health well-being. If you are passionate about making a difference then we want to talk to you. We offer employees a dynamic, collaborative work environment along with a comprehensive range of benefit selections to support your total wellness, including several 100% employer paid benefits.
SCOPE OF ROLE
Reporting to the Team Manager, Revenue Cycle, the Account Analyst is responsible for the entirety of assigned payers, from claims follow up to appeals and resolving payment variances. You will work with insurance carriers to ensure timely accurate payment for services rendered. The Account Analyst is responsible for supporting the revenue cycle functions of the organization.
*The role can be a remote position after a 5-6 week training period, with the employee living within the Cleveland, Ohio area.
HOW YOU’LL SUCCEED
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- Manage assigned payments, denials, collections, and reporting for assigned payers until resolved.
- Submit appeals and/or resolve claim rejections, underpayments and denials.
- Analyze work queues and reports to identify and analyze denial trends, payment variances and provider mapping issues
- Initiate insurance follow up on aged, unresolved claims to ensure accurate reimbursement
- Regularly review resource material such as BH Redesign Manual, FQHC information to ensure carriers are adhering to regulations
- Identifying invalid denials and working with leadership to escalate to Payer Representative
- Maintain clear communication with staff, referents or designated liaison persons.
- Monitor and enforce clients rights and confidentially, and ensure high ethical standards.
- Accountable for all aspects of assigned payer set up and execution; develop and implement strategies under strategy of the Chief Financial Officer.
- Comply with all agency policies and procedures.
- Maintain all aspects of HIPAA, promoting patient confidentiality and right to privacy.
- May be required to perform remote services as determined by Signature Health.
- Adherence and completion of compliance training provided by Signature Health.
- Responsible for and completes all productivity/documentation requirements.
- Participate in all assigned staff meetings and staff development programs.
- Maintain regular and punctual attendance.
- Other duties as assigned.
KNOWLEDGE & EXPERIENCE
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- High School Diploma or equivalent required.
- 3+ years’ experience in healthcare, primary medicine or behavioral health billing preferred.
- Knowledge of ICD Diagnosis, ICD Procedure codes, CPT codes and medical terminology required.
- Experience in billing private insurance a preferred.
- Proficiency in Microsoft Office Word, PowerPoint and intermediate-level Excel skills.
COMPETENCIES ____________________________________________________________________________
- Analytical
- Attention to Detail
- Collaboration
- Communication
- Teamwork
- Problem Solving
- Strong Follow Through
WORKING CONDITIONS
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- In-home high-speed internet is required. DSL, cable or fiber internet service with the ability to hardwire via Ethernet from cable modem to a PC with a download speed of at least 25 mbps and an upload speed of at least 15 mbps.
- Work is normally performed in a typical interior/office/clinical work environment.
- While hours of operation are generally standard, flexibility to work evenings and extended hours may be required.
- Requires periods of sitting, standing, telephone, and computer work.
- Hearing: adequate to hear clients or patients in person, over the telephone or through telehealth technology.
- Speaking: adequate to speak to clients or patients in person, over the telephone or through telehealth technology.
- Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.
- Physical effort required: occasional lifting and carrying items weighing up to 15 pounds, unassisted.
- Possible exposure to blood borne pathogens while performing job duties.
- Frequent bending, reaching, and repetitive hand movements, standing, walking, squatting and sitting, with some lifting, pushing and pulling exerted regularly throughout a regular workday.
- Sufficient dexterity to operate a PC and other office equipment.
ADDITIONAL INFORMATION
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- FLSA Status: Non-Exempt
- Internal Job Code: 1150
- Revenue Status: Non-Revenue Generating
- Last Revision Date: 3/2/2021
This Success Profile is not an exhaustive list of all functions or requirements that you may be required to perform; you may be required to perform other job-related assignments as requested by your supervisor or the company. You must be able to perform the essential functions of the position satisfactorily; however, if requested, reasonable accommodations may be made to enable you to perform the essential functions of this job, absent undue hardship. Signature Health may revise this Success Profile at any time, with or without advanced notice.
All employees of Signature Health are required to comply with the Signature Health Annual Influenza Vaccination Policy and the Federal COVID-19 Vaccination Mandate. Both policies require employees to obtain and provide documentation of the respective vaccinations. Medical and/or religious exemptions may be requested, with proper supporting documentation, and will be review by the designated Signature Health Review Committee(s). Exemption requests are not guaranteed to be approved.