Benefits Systems Analyst - Healthcare jobs in Massachusetts
Benefits Systems Analyst - Healthcare implements and maintains benefits systems for managed care and provider data. Assigns the rate coding to ensure the system takes the appropriate discounts, per diems, case costs, and fee schedule. Being a Benefits Systems Analyst - Healthcare coordinates the implementation and verification of loading the fee schedules. Runs analysis to verify the accuracy of the system. Additionally, Benefits Systems Analyst - Healthcare leads the training of fee loading processes and ensures coding and schedules are accurate. May require a bachelor's degree. Typically reports to a supervisor. The Benefits Systems Analyst - Healthcare works independently within established procedures associated with the specific job function. Has gained proficiency in multiple competencies relevant to the job. To be a Benefits Systems Analyst - Healthcare typically requires 3-5 years of related experience. (Copyright 2024 Salary.com)
Recently Added Benefits Systems Analyst - Healthcare jobs
Jr Insurance Benefits Analyst
- Cape Cod Healthcare
-
Hyannis, MA
FULL_TIME
-
- Troubleshoot and evaluate work product of staff, make recommendations to management and assists with implementing changes.
- Participate with management in strategizing for Process Improvement initiatives to improve cash flow.
- Attend and participate in management meetings.
- Assists management on special organizational projects for CCHC.
- Provide input and feedback for employee evaluations.
- Work collaboratively with Patient Access Managers, Scheduling Managers, Business Office Managers, Vendors and Customers across the enterprise to ensure that Registrars and Schedulers are fully capable of using technology to properly register our patients.
- Assists with review of financial clearance and registration procedures and ensure effective communication with physician practices, patients and internal departments.
- Work with department managers to continuously identify and correct issues identified by reporting.
- Assist Patient Access Managers with Quality Control assessments of their staff related to eligibility and pre-registration errors.
- Verifying insurance eligibility using available technologies, payer websites, or by phone contact with third party payers. Working in accordance with required State and Federal regulations and CCHC policies.
- Contact patients as needed to gather demographic and insurance information, and updates patient information within the EMR as necessary.
- Ensure correct insurance company name, address, plan, and filing order are recorded in the patient accounting system.
- Processes outgoing referrals to specialists outlined by the patient’s insurance plans in a timely manner.
- Utilize payer websites and/or Epic/Experian to process, obtain and verify insurance referrals.
- Utilizing the incoming referral work queue will request, obtain and link insurance referral authorizations to upcoming specialty appointments as outlined by the patient’s insurance plan in a timely manner.
- Track, document and communicate the status of referrals as they move through the referral process, ensuring proper follow-up, documentation and communication when the referral has been completed.
- Maintain core competency and current knowledge of regulatory payer authorization and eligibility requirements.
- Obtain and verify authorizations to ensure payment for services provide through CCHC.
- Work accounts in assigned work queues to resolve billing errors and edits to ensure all claims are filed in a timely manner.
- Follow-up and work registration/authorization claim denial work queues to identify and take the appropriate action to fix errors for claim resubmission to payers.
- Maintain close coordination with Practice Managers, Clinical/Front End staff, and Physicians to advise of any changes or updates to insurance payer requirements.
- Responds to all practice inquiries and questions about insurances, referrals, and authorizations.
- Meets and maintains daily productivity and quality standards established in departmental policies.
- Assists the department, work unit and/or fellow staff members by cross-covering for absences, participating in special projects, and attending ongoing training sessions, etc.
- Attends and participates in educational programs, in-service meetings, workshops, and other activities as related to job knowledge and state guidelines.
- Ability to work with minimum supervision and in a team environment.
- Performs other job-related duties and assignments as requested/directed.
- Demonstrates the ability to adjust to unexpected changes to assure all responsibilities/duties are met during absences or increases in work volume.
- Associate Degree strongly preferred, High School diploma or GED required
- Minimum of one (1) year experience in a large hospital’s Revenue Cycle Department with an emphasis on Patient Access and or Scheduling is strongly desired.
- Experience with large hospital information systems is required, preferably Epic and/or Siemens is preferred.
- Excellent interpersonal, problem solving and critical thinking skills
- Excellent PC skills with a strong emphasis on the Outlook suite of products
- Excellent verbal and written communication skills are required.
- Medical Terminology knowledge preferred
- Experience utilizing insurance payer websites preferred.
To financially clear all scheduled patients within 48 hours of their office visit and/or procedure. Resolve issues with accounts due to errors with authorizations, registration and eligibility. The job responsibilities include working effectively with the interdisciplinary team of Physician Offices, Insurance Companies, and CCHC Revenue Cycle to assure the protection and recovery of all revenues associated with services provided by MACC. Assists with the review, analysis, development, and implementation of Process Improvement changes for the department to improve efficiency and workflow.
Schedule Details
40 hours per week, Mon-Fri, 8:30a-4:30p, No Weekends & No Holidays
Organization
Medical Affiliates of Cape Cod
Primary Location
Massachusetts-Hyannis
Department
MAC-Admin Allocated - PCP Only
Employee Classification
Regular-Regular
Shift
Day
Weekend Shifts
None
Holiday Shifts
None
Posting Start Date
Mar 28, 2024
Posting End Date
Ongoing - 14 Days Ago
Information Systems Administrator and Analyst
- LABOURE COLLEGE OF HEALTHCARE INC
-
Milton, MA
FULL_TIME
- GENERAL SUMMARYUnder the direction of the Director of Information Technology, the Information Systems Administrator and Analyst is responsible for the maintenance, management, reporting, data integrit...
- Just Posted
Business Systems Analyst - Finance
- Veeva Systems
-
Boston, MA
FULL_TIME
- Veeva Systems is a mission-driven organization and pioneer in industry cloud, helping life sciences companies bring therapies to patients faster. As one of the fastest-growing SaaS companies in histor...
- 30 Days Ago
Jr Insurance Benefits Analyst (Per Diem)
- Cape Cod Healthcare
-
Hyannis, MA
PER_DIEM
- Troubleshoot and evaluate work product of staff, make recommendations to management and assists with implementing changes. Participate with management in strategizing for Process Improvement initiativ...
- 4 Days Ago
Healthcare Analyst
- Emerson Health
-
Concord, MA
FULL_TIME
- Job Summary: Reporting to the Director, Physician Practice Billing, the Healthcare Analyst serves a key resource for EPA and the EPA revenue cycle team supporting the Service Line Directors, Office Ma...
- Just Posted
Product Manager, Healthcare Systems
- TriNetX, LLC.
-
Cambridge, MA
FULL_TIME
- POSITION TITLE: PRODUCT MANAGER, HEALTHCARE SYSTEMS LOCATION: REMOTE US This position reports to our global HQ in Cambridge, MA and is fully remote within the US. Travel is expected when needed and lo...
- 14 Days Ago
Benefits Systems Analyst - Healthcare jobs at Popular Companies
Benefits Analyst
- ADE ADESA Inc
-
Carmel, IN
- Who We Are: At OPENLANE we make wholesale easy so our customers can be more successful. We’re a technology company build...
- 6/12/2024 12:00:00 AM
Benefits Analyst
- Toyota Material Handling
-
- COMPANY OVERVIEW: Toyota Industries North America, Inc., an American Holding Company providing shared professional servi...
- 6/11/2024 12:00:00 AM
Benefits Analyst I
- Transdev Inc.
-
Lombard, IL
- About Transdev:Cities, counties, airports, companies, and universities across the U.S. contract with Transdev to operate...
- 6/9/2024 12:00:00 AM
Benefits Analyst
- Turnberry
-
Aventura, FL
- Company Overview: Turnberry is a leader in the design, development, and management of multi-use real estate properties. ...
- 6/9/2024 12:00:00 AM
Employee Benefits Analyst
- World Insurance Associates LLC
-
Syosset, NY
- Summary Paul Global Benefits (PGB) is now a part of World Insurance Associates. World Insurance Associates is a unique i...
- 6/8/2024 12:00:00 AM
Employee Benefits Analyst
- U.S. Retirement & Benefits Partners
-
Rochester, NY
- COMPANY OVERVIEW U.S. Retirement & Benefits Partners (USRBP) is one of the largest independently owned insurance brokera...
- 6/8/2024 12:00:00 AM
Employee Benefits Analyst
- Brown & Brown, Inc.
-
Houston, TX
- Built on meritocracy, our unique company culture rewards self-starters and those who are committed to doing what is best...
- 6/8/2024 12:00:00 AM
Employee Benefits Analyst MNN9598
- Capstone Search Group
-
Chicago, IL
- Job Description Job Description About the Role The Employee Benefits Analyst is with one of the country’s largest indepe...
- 6/7/2024 12:00:00 AM
About Massachusetts
Massachusetts is the 7th-smallest state in the United States. It is located in the New England region of the northeastern United States and has an area of 10,555 square miles (27,340 km2), 25.7% of which is water. Several large bays distinctly shape its coast. Boston is the largest city, at the inmost point of Massachusetts Bay, and the mouth of the Charles River.
Despite its small size, Massachusetts features numerous topographically distinctive regions. The large coastal plain of the Atlantic Ocean in the eastern section of the state contains Greater Boston, along with most of the state's po...
Source: Wikipedia (as of 04/11/2019). Read more from Wikipedia
Income Estimation for Benefits Systems Analyst - Healthcare jobs
$66,072 to $88,705