Revenue Cycle Claims Analyst I - PPG CBO - REMOTE

The PB CBO team is responsible for all insurance AR for our professional provider billing.  The team works in conjunction with the coding, revenue integrity, denial management, and practices to ensure appropriate AR is captured and reimbursed by payers.

ACCOUNTABILITIES

 

1.    Works with revenue cycle staff and leadership to prioritize department information needs.

2.    Supports the PB CBO with reporting needs and analyzing data.

3.    Gathers, organizes, and interprets PB CBO data to identify trends for process improvement

4.    Works with PB CBO leadership to recommend process improvements, and monitors progress with leadership.  Collaborating with the team and other revenue cycle departments to improve denial workflows, reduce avoidable write-offs, and improve net cash.

5.    Works with vendors and AP to process and reconcile monthly invoicing.  

6.    Achieves sufficient expertise with Epic, Microsoft products, BI systems, and any other applicable program to support PB CBO reporting needs.

7.    Works as a liaison with Quadax, and any other claim related vendor, to ensure accurate claim filing and receipt.

8.    Performs continuous reconciliation of claims and AR to ensure payers are receiving and processing claims.

9.    Communicates effectively with staff, leadership, and vendors related to process improvement, performance standards, and accountability

10.    Performs other duties as assigned

REQUIRED QUALIFICATIONS
Education:    Associate's degree
Skills:    

• Must pass a basic skills test and scoring a minimum of 80% Must have exemplary organizational skills


• Must be PC proficient, especially in MS Excel

Experience:    Professional Claims Billing and Follow up, with AR analysis 

 

PREFERRED QUALIFICATIONS
Education:    Bachelor's degree
Experience:    1-3 years in Professional billing or similar revenue cycle experience

ADDITIONAL EXPERIENCE

• Must be proficient in data analysis


• Must be flexible with the ability to adapt to change quickly and think conceptually Must have strong communication and interpersonal skills


• Team mentality


• Ability to multi-task in a fast-paced environment Impeccable attendance


• Must be able to move about office and between workstations


• Must be able to occasionally lift, move and carry up to 20lbs of materials

ProMedica is a mission-based, not-for-profit integrated healthcare organization headquartered in Toledo, Ohio.  For more information, please visit

Qualified applicants will receive consideration for employment without regard to race, color, national origin, ancestry, religion, sex/gender (including pregnancy), sexual orientation, gender identity or gender expression, age, physical or mental disability, military or protected veteran status, citizenship, familial or marital status, genetics, or any other legally protected category. In compliance with the Americans with Disabilities Act Amendment Act (ADAAA), if you have a disability and would like to request an accommodation in order to apply for a job with ProMedica, please contact employment@

Equal Opportunity Employer/Drug-Free Workplace