Reimbursement Analyst - Dallas,TX in Plano, TX at HOSPITAL BUSINESS SERVICES, INC - TEXAS DALLAS

Date Posted: 4/5/2018

Job Snapshot

  • Employee Type:
  • Location:
    5212 Tennyson Parkway
    Plano, TX
  • Job Type:
  • Experience:
    Not Specified
  • Date Posted:

Job Description

JOB SUMMARY: Under the supervision of the PFS Director, the Reimbursement Analyst position is responsible for accurate and timely payment analysis of managed care contracts to determine that appropriate reimbursement is received. Utilizing many complex and varying regulations, guidelines and systems, analyzes payments received from insurance companies to assure maximum and correct reimbursement receivables. Proactively works with payers and in-house resources to identify and resolve issues that hinder optimal and correct account payment. Utilizes and applies the appropriate regulations in order to assure compliance in payment practices.

1.Reviews all contract and non-contract payments for accuracy on a daily basis.
2.Calculates contract adjustments accurately and in a timely manner.
3.Supports informational needs relating to contract negotiations and the practical application of contracts in securing appropriate reimbursement.
4.Provide the Director and Managed Care Department feedback regarding payer non-compliance with the terms of hospital contracts.
5.Review and initiate timely resolution of overpayment, underpayments, and credit balances.
6.Accurately documents EOB/RA information in the MediTech system.
7.Meets cash goal requirements and all other KPIs