Joslin Diabetes Center

Claims Analyst (Patient Accounts)

US-MA-Boston
1 month ago
Job ID
R3005-17
# Positions
1
Category
Clinic

Overview

The Claims Analyst is responsible for completing all aspects of claims processing in a timely and accurate manner in accordance with company policies and procedures.

 

Hours are Monday-Friday 8:00 am - 4:30 pm.

Responsibilities

 

  • Imports charges from the electronic medical record system to the billing system on a daily basis, ensuring the accurate transfer of data. Monitors the accuracy and volume of charges entered into billing system via charge import and manual entry.
  • Validates all claims prior to submission to third-party payers with the goal of submitting “clean claims” to payers upon first submission. Reviews and corrects errors in charges relating to claim, demographic, and insurance information prior to and following submission to insurance carriers.
  • Submits claims to third-party payers via electronic claim files. Prepares and prints paper claims to be sent to third-party payers.
  • Coordinates the resolution of system issues related to charge and claim processing with MIS, vendors, and third-party payers when necessary.
  • Monitors and reports ongoing problems with claim production, import, or entry. Escalates all concerns or issues to the Manager timely to avoid any significant delay in claims adjudication.
  • Conducts daily reporting of claim submission data and volumes. Supports the Patient Accounts Manager in preparing daily, weekly, and monthly reports.
  • Performs other systems tasks and general Patient Accounting tasks as assigned, including but not limited to; answering the general Patient Accounts phone line, data entry and other department specific projects.

 

Qualifications

  • High school diploma required - Associates or Bachelor’s degree preferred
  • 2+ years of healthcare related experience preferred in Patient Accounts or Management Information Systems department in a medical business environment
  • Knowledge of CPT and ICD9 coding preferred.
  • Proficiency in keyboarding (minimum 45 wpm) to enter charges, payments and adjustments into billing system
  • Ability to perform repetitive work according to set procedures, sequence and pace
  • Ability to act in lead capacity to ensure Data Entry Specialists complete appropriate and timely entry of charges, payments, and adjustments into the billing system
  • Ability to perform effectively under pressures of deadlines and fluctuating work loads

 

Joslin Diabetes Center is an Equal Opportunity Employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability status, protected veteran status or any other status protected by law.

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