Revenue Cycle Analyst Full Time

Position Goal

Maintains overall understanding of assigned payor. Serves as a liaison between the Hughston Surgical Center and the assigned payor. Performs follow-up activities through the entire claims adjudication cycle.

Position Responsibilities

• Provide coverage backup during employee shortages.
• Post all insurance payments, denials, and other revenue payments promptly, accurately and efficiently.
• Meets assigned productivity and quality assurance goals as established by department leadership
• Generate timely claims to third party payers and/or patients.
• Research and write up refunds for overpayments as needed.
• Assists patients with questions/payments on their accounts as necessary/track balances.
• Monitor claims for accuracy in payment received from insurance companies.
• Write timely appeals to insurance companies where necessary, monitor this process accordingly.
• Collect on delinquent insurance accounts.
• Prepares monthly reports related to HIM and Revenue Cycle activities.

Experience: 2 years-experience required of medical collections that demonstrates the following: insurance/claims processing, posting, modifier use, and understanding of EOB’s, navigation of payor sites, HCFA\UB, determining eligibility/co E insurance / copayments and deductibles. Must have knowledge of front end (patient payments, demographic to file the claim) and back office billing office practices (the filing and follow up of the claim). Physician practice, ambulatory surgical or hospital setting preferred.
Education: High School Diploma or equivalent required.
Special Qualifications: Must be able to work independently. 

The Hughston Clinic, The Hughston Foundation, The Hughston Surgical Center, Hughston Clinic Orthopaedics, Hughston Medical, Hughston Orthopaedics Trauma, Hughston Orthopaedics Southeast and Jack Hughston Memorial Hospital participate in E-Verify. This company is an equal opportunity employer that recruits and hires qualified candidates without regard to race, religion, color, sex, sexual orientation, gender identity, age, national origin, ancestry, citizenship, disability, or veteran status.