Insurance Recovery Analysts are medical billers that are responsible for processing commercial, governmental and/or third-party liability (workmans compensation, general liability, and motor vehicle liability) medical claims. This position ensures that ClaimAssists clients (hospitals) recover the maximum allowable medical fees in the most timely, efficient, and confidential manner.
ESSENTIAL FUNCTIONS:
- Investigates, negotiates, bills and follows-up for payment regarding first and third-party claims involving any and all coverages, liability, and legal issues.
- Identifies viable payers, obtains IBs, UBs, HCFAs, correspondence, and medical records when necessary.
- Maintains the highest level of privacy in accordance with HIPAA requirements and laws.
- Works their inventory by route while maintaining an acceptable level of aged accounts receivable.
- Contacts patients, payers, hospitals, attorneys, employers, and any other parties involved to collect the necessary information and ensure reimbursement for our client.
- Recovers maximum dollars for the hospital through coordination of benefits in a timely manner.
- Appeals claims when applicable.
- Meets monthly company, team, and individual goals, and all deadlines set by the Team Lead and Manager, Operations.
- Completes special projects, as requested.
QUALIFICATIONS:
- Minimum of four (4) years of directly related industry experience.
- Emdeon/ChangeHealthcare billing experience is a plus.
- EPIC, CERNER and/or MEDITECH experience is a plus.
- Experience working claims in multiple states is a plus.
- Strong technical knowledge in one or more areas of commercial insurance, government insurance, workmans compensation, motor vehicle liability, general liability and claims processing systems.
- Knowledge of medical and insurance terminology.
- Knowledge of coordination of benefits.
- Working knowledge of FACS (ClaimAssists host system) or comparable management software system.
- Ability to speak confidently over the phone
- Basic knowledge of Microsoft Excel and Word.
- Ability to provide quality customer service to all parties.
- Ability to work in a fast-paced environment
- Demonstrated knowledge of state laws and insurance statutes.
- Excellent interpersonal and verbal/written communications skills.
- Highly motivated, self-starter, organized and detail-oriented.
- Ability to work well individually, as well as part of a team.
- Coachable: receptive to feedback, willing to learn, embraces continuous improvement, and responsive to change.
- Ability to maintain a predictable and consistent full-time work schedule.
EDUCATIONAL REQUIREMENTS:
- Bachelors degree in business or related field.
- Insurance Institute Certificate(s) highly desirable.
- Five (5) years of directly related experience in lieu of degree.
The CCS Companies is an Equal Opportunity Employer
This document is considered CCS Proprietary and Confidential.
Skills Required
- Minimum four years of directly related industry experience
- Bachelor’s degree in business or a related field
- Five years of directly related experience may substitute for the degree
- Strong technical knowledge of commercial insurance, government insurance, workers’ compensation, motor vehicle liability, general liability, and claims processing systems
- Knowledge of medical and insurance terminology
- Knowledge of coordination of benefits
- Working knowledge of FACS or comparable management software
- Ability to speak confidently over the phone
- Basic knowledge of Microsoft Excel and Word
- Ability to provide quality customer service
- Ability to work in a fast-paced environment
- Knowledge of state laws and insurance statutes
- Excellent interpersonal and verbal and written communication skills
- Ability to work independently and as part of a team
- Ability to maintain a predictable and consistent full-time work schedule
- Emdeon or ChangeHealthcare billing experience
- EPIC, CERNER, or MEDITECH experience
- Experience working claims in multiple states
- Insurance Institute certificates
What We Do
The CCS Companies is a Norwood, Massachusetts-based business process outsourcing provider serving organizations across major industry verticals. Its operations include first- and third-party debt collection, consumer payment-obligation servicing, claims and subrogation processing, insurance billing, revenue-cycle management, and multichannel customer communications. The company emphasizes customized outsourcing solutions and a customer-service approach, drawing on more than six decades of volume-based servicing experience.
