Top 1 Billing analyst Jobs in Southport, Nc

Claims Analyst
J Arthur Dosher Memorial Hospital —Southport, NC
- $20.00 - $21.70 an hour
- Full-time
- HIPAA
- Research
- Mid-level
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7d

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Claims Analyst

J Arthur Dosher Memorial Hospital -
Southport, NC

Quick Apply

Job Details

Full-time
$20.00 - $21.70 an hour
7 days ago

Qualifications

HIPAA compliance
Spreadsheets
Health insurance policy knowledge
HIPAA
Medical claims processing software
High school diploma or GED
ICD-10
Insurance regulation
Medical terminology
Technical Proficiency
Data analysis software

Full Job Description

Description:

Full-Time (40 hours)

Responsible for reviewing and investigating healthcare insurance claims to determine appropriate contractual payments and adjustments, validity and accuracy

Functions of the Position (not an exhaustive list):

Investigate claims: Research and evaluate claims for legitimacy and accuracy, which may involve gathering additional information from other parties including payers, providers and other departments
Contract Management Platform: Use and maintenance of existing contract management software, including uploading, maintaining and removal of payer contracts.
Reporting: Maintaining, analyzing and providing reporting metrics related to payer reimbursement data in a timely and predictable manner
Process claims: Analyze insurance claims according to policy provisions and guidelines
Determine eligibility: Interpret complex policy language and provisions to determine coverage and appropriate reimbursement amounts
Detect fraud: Analyze claim data and identify irregularities or patterns that may indicate fraudulent activity

Requirements:

Qualification

1. Education:

High School diploma or equivalent
Hospital billing experience preferred

2. Physical Demands:

Requires sitting for long periods; sometimes in a confined space
Lifting/carry up to 20lbs
Repetitive finger movement
Manual dexterity and mobility
Reaching at all levels
Stooping, bending, kneeling, crouching
Work with machinery with moving parts

3. Experience:

Previous experience in claims processing or medical billing preferred
Knowledge of policies and regulations: Strong understanding of insurance policies, coverage limitations, and industry-specific regulations (e.g., HIPAA for health claims)
Claims management software: Proficiency with claims processing and management software
Data analysis: Ability to collect, analyze, and interpret claims data using tools like Microsoft Excel and other databases
Medical terminology: Familiarity with medical codes (CPT-4 and ICD-10) for health claims and basic legal principles.

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Claims Analyst

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