Senior Healthcare Claims Analyst - Remote

What is Aspirion?

Aspirion Health Resources is an industry-leading provider of complex claims management services. We specialize in Motor Vehicle Accidents, Worker’s Compensation, Veterans Administration and Tricare, Complex Denials, Out-of-State Medicaid, and Eligibility and Enrollment Services. Our employees work in an environment that is both challenging and rewarding. We ask a lot out of our team members and in return we offer flexibility, autonomy, and endless opportunities for advancement. As we are committed to growth within the complex claims industry, we offer the same growth to our employees.

What do we need?

We are looking for a talented and proficient Senior Healthcare Claims Analyst to join our growing team. The Senior Claim Analyst provides high-level claim related functionality in an advanced specialty role for projects. This individual needs to be self-motivated, driven, and have advanced knowledge of revenue cycle operations and claims processes. The Senior Claim Analyst will be tasked with special projects as designated by their management team, assist as an additional knowledge resource for Claim Analyst, and support management team.

What will you provide?

• Works assigned accounts independently, efficiently, toward resolution while maximizing proficiency
• Partner with both internal and external resources to find root cause of claims with adverse financial outcomes to ensure resolution
• Provide specific project feedback as it relates to new start-ups or existing operations
• Handle difficult claim, patient, and third party follow-up problems
• Establish network of working relationships with individuals at insurance companies
• Proactively identify and manage trends, issues, and maintain written documentation of findings
• Performs analysis of accounts to determine necessary action for resolution of account
• Utilize collection talk off guidelines to resolve accounts
• Contacts payers to obtain payment or status to resolve accounts while maintaining good payer relations
• Contacts patients/guarantors where necessary to verify/gather information to properly handle accounts
• Follows hospital specific processes when returning an account for hospital action (i.e. rebilling, medical records requests, appeals, etc.)
• Update accounts with any new or corrected information received on an account
• Documents in hospital’s collection system all action taken on an account where appropriate

Other duties that may fall under scope:

• Assist team members to clarify assignments, milestones, and deliverables
• Provide research based input
• Assist with project implementation, lead, support or provide specific deliverables ensuring timely project kick-offs
• Assist team members with questions, concerns, and complaints from insurance companies, patients, and other personnel
• Evaluate critical areas of opportunities within existing client scope of services ensuring timely corrective action
• Participate in highly developed strategy and planning sessions with management team
• Maintain a clear project scope and motivate team members
• Maintain a working knowledge of all team operations and associated facility processes
• Practice and adhere to the “Code of Conduct” philosophy and “Mission and Value Statement”