Note: The job is a remote job and is open to candidates in USA. Lifepoint Health is a community-based healthcare organization focused on making communities healthier. The Claims Analyst manages billing, collections, claims follow-up, appeals, and accounts receivable across multiple facilities while ensuring compliance with payer requirements and accurate reimbursement. The role also supports staff and collaborates with Utilization Management and other internal departments to resolve billing issues.
Responsibilities
- Accurately performs billing and collections for multiple facilities for all payors
- Provide professional and technical support to staff across multiple departments
- Respond to inquiries from insurance carriers, patients, and family members regarding billing and account balance questions
- Monitor and review financial systems to ensure accurate revenue recognition and maintain appropriate accounts receivable levels aligned with payer mix and acuity
- Collaborate with Utilization Management departments to ensure pre-certifications, authorizations, and appeals are completed accurately and on time
- Perform effective and timely follow-up on insurance claims to secure appropriate reimbursement
- Analyze explanations of benefits (EOBs), remittances, and explanations of payment (EOPs) to identify discrepancies or underpayments
- Research and resolve claim issues
- Prepare, submit, and track appeals for denied claims through resolution
- Prepare for and actively participate in weekly Accounts Receivable (AR) meetings
Skills
- Applicants should have a high school diploma required
- With 3–5 years of computerized medical billing experience required
- And working knowledge of Medicare/Medicaid and institutional billing requirements
- Strong knowledge of Medicare/Medicaid guidelines and UB04 billing requirements
- Proficiency in computerized medical billing systems
- Ability to manage multiple facilities and payor types simultaneously
- Strong analytical and problem-solving skills
- Effective communication with internal teams and external stakeholders
- Detail-oriented with strong organizational skills
- Ability to work in a fast-paced, high-volume, production-based environment
- Understanding of Hospital Revenue Cycle processes within a multi-facility healthcare environment
- You must be authorized to work in the United States without employer sponsorship
- Associate degree preferred
- With behavioral healthcare experience preferred
Benefits
- Remote work arrangement
- Multiple levels of medical, dental and vision coverage for full-time and part-time employees.
- Life, accident, critical illness, and hospital indemnity insurance.
- Short- and long-term disability.
- Paid family leave and paid time off.
- Higher education and certification tuition assistance.
- Loan assistance.
- 401(k) retirement package and company match.
- Mental, physical, and financial wellness programs, including free gym memberships, virtual care appointments, mental health services, and discount programs.
- Ongoing learning and career advancement opportunities.
Company Overview