Senior Account Analyst at Signature Health, Inc. in Mentor, Ohio

Job Description:

Description

At Signature Health, our purpose is to provide integrated healthcare for our community specializing in patients with mental illness and/or addiction because we want people to realize their highest potential. If you align with our core values, putting people first, striving for excellence in the work you do each day and have a can do mindset, then Signature Health is the best place for the next step in your rewarding career. As a full-time employee, you will have access to the following employer/employee paid benefits:

• Medical, Dental, Vision, 401k match, HealthJoy - a no cost medical and mental health online resource available Day 1, and much more


• Robust earned paid time off program (PTO)


• Federal Loan Forgiveness Program (available on eligible roles)


• Tuition & Professional Development Assistance

SCOPE OF ROLE
Reporting to the Manager, Revenue Cycle, the Senior Account Analyst is responsible for the entirety of assigned payers and departments, from claims follow up to appeals and resolving payment variances. The Senior Account Analyst will work with insurance carriers to ensure timely billing of services and accurate payment for services rendered and responsible for supporting the revenue cycle functions of the organization.

HOW YOU'LL SUCCEED

• Manage payments, denials, collections, and reporting for assigned payers until resolved.


• Submit appeals and/or resolve claim rejections, underpayments and denials.


• Analyze work queues and reports to identify denial trends, payment variances and provider mapping issues.


• Initiate insurance follow up, reviewing aged, unresolved claims to ensure accurate reimbursement.


• Regularly review resource material such as the BH Redesign Manual Medicaid, Medicare FQHC billing rules, and Dental Operations manuals to ensure insurance carriers are adhering to regulations and billing requirements.


• Identifying invalid denials and work with Revenue Cycle leadership to escalate systemic issues to payer representatives.


• Maintain clear communication with staff, or designated liaison persons.


• Other duties as assigned.

Requirements

KNOWLEDGE & EXPERIENCE

• High School Diploma or equivalent required.


• 3+ years' experience in healthcare, primary medicine or behavioral health billing required.


• Knowledge of dental billing and insurance required.


• Knowledge of ICD-10 Diagnosis CPT and HCPCs codes and medical terminology is a plus.


• Proficiency in Microsoft Office Word, PowerPoint and intermediate-level Excel skills.

WORKING CONDITIONS

• Work is normally performed in a typical interior/office/clinical work environment. Flexibility to work remote with some in office days required once requisite training requirements for 6 week period is completed.


• In-home high-speed internet is required. DSL, cable or fiber internet service with the ability to hardwire via Ethernet from cable modem to a PC with a download speed of at least 25 mbps and an upload speed of at least 15 mbps.


• While hours of operation are generally standard, flexibility to work evenings and extended hours may be required.


• Requires periods of sitting, standing, telephone, and computer work.


• Hearing: adequate to hear clients or patients in person, over the telephone or through telehealth technology.


• Speaking: adequate to speak to clients or patients in person, over the telephone or through telehealth technology.


• Vision: Visual acuity adequate to perform job duties, including reading information from printed sources and computer screens.


• Physical effort required: occasional lifting and carrying items weighing up to 15 pounds, unassisted.


• Possible exposure to blood borne pathogens while performing job duties.


• Frequent bending, reaching, and repetitive hand movements, standing, walking, squatting and sitting, with some lifting, pushing and pulling exerted regularly throughout a regular workday.


• Sufficient dexterity to operate a PC and other office equipment.

This Success Profile is not an exhaustive list of all functions or requirements that you may be required to perform; you may be required to perform other job-related assignments as requested by your supervisor or the company. You must be able to perform the essential functions of the position satisfactorily; however, if requested, reasonable accommodations may be made to enable you to perform the essential functions of this job, absent undue hardship. Signature Health may revise this Success Profile at any time, with or without advanced notice.

All employees of Signature Health are required to comply with the Signature Health Annual Influenza Vaccination Policy. This policy requires employees to obtain an annual flu vaccination. A medical and/or religious exemption may be submitted for review by the Signature Health Review Committee. Exemption requests are not guaranteed to be approved. Signature Health is a drug-free workplace. After receiving a conditional job offer, all applicants must successfully pass a pre-employment drug screen.

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