Analyst I, Credit & Collections

Analyst I, Credit & Collections responsible for collecting overdue payments and establishing re-payment arrangements. Negotiates liability settlement of medical claims with third parties or healthcare providers; seeks reimbursement from healthcare providers and/or ensures payment of claims by appropriate insurance carrier.

Requirements

• Collecting overdue payments and establishing re-payment arrangements
• Negotiating liability settlement of medical claims with third parties or healthcare providers
• Seeking reimbursement from healthcare providers and/or ensuring payment of claims by appropriate insurance carrier
• Analyzing and reviewing paid medical claims to ensure the recovery amount is consistent with settled agreement
• Applying coordination of benefits (COB) practices to minimize overpayment by client
• Performing onsite auditing of healthcare providers' accounting records to identify and recover overpayments made by client
• Reviewing and interpreting employee benefit plan language or insurance contracts to ensure the plan rights are adhered to
• Ensuring compliance with federal, state and local legislation regarding reporting and privacy issues