Revenue Cycle Claims Billing Analyst job at CenterWell Home Health in US National
Title: Revenue Cycle Claims Billing Analyst
Location: Remote Nationwide
time type
Full time
job requisition id
R-405388
Job Description:
Become a part of our caring community and help us put health first
As the Revenue Cycle Claims Billing Analyst, you will ensure accurate and efficient billing processes across the organization. The main responsibilities you will be responsible for include daily monitoring of accounts receivable and claim submissions, identifying and resolving billing errors, and addressing claim rejections. You will also research billing issues and recommend process improvements.
Update the A/R pivot table for daily review of accounts receivable status.
Review recently submitted claims to identify and resolve issues with uploading to RevConnect, including mass rebilling for claims not transmitted.
Identify opportunities for billing project improvements and resolve similar billing issues.
Review Non-Medicare payers in RevConnect to detect and correct mass billing errors causing claim rejections.
Ensure root causes of rejections are resolved to prevent continued issues.
Help research billing issues to determine and implement appropriate resolutions.
Monitor new payer Quick Reference Guides (QRGs) and contract updates to ensure payers are paying according to contract terms; resolve any discrepancies.
Track week-over-week trends for billed and unbilled accounts.
Monitor for significant billing issues that may affect revenue collection.
Identify solutions to reduce aging accounts (over 90 days) and achieve main indicator targets.
Track month-over-month trending to identify opportunities for improvement in billing, procedures, and collections to support organizational goals.
Monitor and report on over 90-day aging trends to resolve denied claims and increase revenue.
Track the top 10 monthly payers and comment types to identify and resolve any increases in billing or claim issues.
Provide detailed reporting and analysis as requested by management.
Help with audit reviews.
Review contracts for accuracy and compliance in claim processing when needed.
Use your skills to make an impact
Requirements:
Minimum of 5 years of experience in billing systems, payer setup, and contract review.
Proficiency in data analysis and reporting.
Data-driven decision-making experience.
Attention to detail and organizational abilities.
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$60,800 - $82,900 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Apply Now
Apply Now
Location: Remote Nationwide
time type
Full time
job requisition id
R-405388
Job Description:
Become a part of our caring community and help us put health first
As the Revenue Cycle Claims Billing Analyst, you will ensure accurate and efficient billing processes across the organization. The main responsibilities you will be responsible for include daily monitoring of accounts receivable and claim submissions, identifying and resolving billing errors, and addressing claim rejections. You will also research billing issues and recommend process improvements.
Update the A/R pivot table for daily review of accounts receivable status.
Review recently submitted claims to identify and resolve issues with uploading to RevConnect, including mass rebilling for claims not transmitted.
Identify opportunities for billing project improvements and resolve similar billing issues.
Review Non-Medicare payers in RevConnect to detect and correct mass billing errors causing claim rejections.
Ensure root causes of rejections are resolved to prevent continued issues.
Help research billing issues to determine and implement appropriate resolutions.
Monitor new payer Quick Reference Guides (QRGs) and contract updates to ensure payers are paying according to contract terms; resolve any discrepancies.
Track week-over-week trends for billed and unbilled accounts.
Monitor for significant billing issues that may affect revenue collection.
Identify solutions to reduce aging accounts (over 90 days) and achieve main indicator targets.
Track month-over-month trending to identify opportunities for improvement in billing, procedures, and collections to support organizational goals.
Monitor and report on over 90-day aging trends to resolve denied claims and increase revenue.
Track the top 10 monthly payers and comment types to identify and resolve any increases in billing or claim issues.
Provide detailed reporting and analysis as requested by management.
Help with audit reviews.
Review contracts for accuracy and compliance in claim processing when needed.
Use your skills to make an impact
Requirements:
Minimum of 5 years of experience in billing systems, payer setup, and contract review.
Proficiency in data analysis and reporting.
Data-driven decision-making experience.
Attention to detail and organizational abilities.
To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.
Satellite, cellular and microwave connection can be used only if approved by leadership.
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.
Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job.
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.
Scheduled Weekly Hours
40
Pay Range
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.
$60,800 - $82,900 per year
Description of Benefits
Humana, Inc. and its affiliated subsidiaries (collectively, “Humana”) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.
About us
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers – all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.
About CenterWell, a Humana company: CenterWell creates experiences that put patients at the center. As the nation’s largest provider of senior-focused primary care, one of the largest providers of home health services, and fourth largest pharmacy benefit manager, CenterWell is focused on whole-person health by addressing the physical, emotional and social wellness of our patients. As part of Humana Inc. (NYSE: HUM), CenterWell offers stability, industry-leading benefits, and opportunities to grow yourself and your career. We proudly employ more than 30,000 clinicians who are committed to putting health first – for our teammates, patients, communities and company. By providing flexible scheduling options, clinical certifications, leadership development programs and career coaching, we allow employees to invest in their personal and professional well-being, all from day one.
Equal Opportunity Employer
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.
Apply Now
Apply Now