Healthcare Claims Analyst - Zero Balance
Healthcare Claims Analyst - Zero Balance
Boost Healthcare
Alameda, CA
See who Boost Healthcare has hired for this role
Location: Remote. Office is headquartered in Alameda, California. What We Do: Boost Healthcare is focused on helping healthcare providers identify and recover revenue. Our service lines include Zero Balance, AR Solutions, and Financial & Strategic Advisory. Our team works with hospitals and physician groups to improve overall revenue by recovering denied and underpaid claims from both commercial and government payers. We provide clients with claims data showing payer performance and root cause analysis of denial and underpayment issues. We assess their overall business performance so they can focus on the patient experience and quality of care and let us reduce administrative burden and help drive their bottom line. Our services are contingency based with no upfront costs to our clients. Position Summary: As a Healthcare Claims Analyst, you will work closely with your team on assigned project(s) to be a trusted point of contact for our clients and team members. The Healthcare Claims Analyst will support the success of the Zero Balance department by evaluating and reviewing contracts between hospitals and insurance carriers and researching trends and why underpayments are occurring. The ideal candidate for this position will have a demonstrated interest in healthcare and a desire to strengthen their analytical, team, leadership, and client relations skills. Primary Duties and Responsibilities:
- Review contracts between hospitals and insurance carriers, model claims data, and identify lost revenue
- Contact responsible party for claim payment
- Prepare and forward claim appeal letters with supporting documentation for denial overturn
- Establish working relationships with individuals at insurance companies
- Communicate with teammates and leadership to discuss and identify trends
- Contact insurance companies via phone, email, and written appeal to recover dollars
- Perform analysis on large data sets to identify underpayment and denial trends
- Conduct research on current laws and regulations pertaining to hospital reimbursement methodology
- Contribute to client decks and weekly reports to track progress of project goals and present to leadership
- Strive to maintain a personal hourly rate by meeting project metrics and goals efficiently
- Attend Privacy and Security Training as required by the HIPAA Awareness Program and comply with all guidelines, policies and procedures to assure sensitive or confidential information is protected in accordance with the HIPAA rules and regulations
- Other duties as assigned
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Seniority level
Entry level -
Employment type
Full-time -
Job function
Finance and Sales -
Industries
Hospitals and Health Care
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