ACU-Serve

Analyst

• Ensure accurate coding, charge capture, and billing practices in compliance with industry standards (i.e., CPT ICD-10, HIPAA)
• Collect data from our Clients daily or weekly, to generate claims using various software platforms.
• Manage and monitor claims to maximize timely and accurate reimbursement, including claim submissions, denial management and appeals.
• Identify opportunities to enhance revenue capture, minimize revenue errors, and reduce bad debt through analysis of key performance indicators.
• Analyze payer contracts, fee schedules and reimbursement to ensure proper reimbursement is made on paid claims.
• Track claims that are pending due to missing or incomplete documentation (i.e.: DIF, RX, authorization, etc.).
• Ensure claims are submitted promptly to insurance companies within their specified filing period.
• Regularly make follow-up calls to insurance providers to check the status of claims not settled within 30 days or their standard processing time.
• Timely submission of appeals to secure correct payment for outstanding claims.
• Address partial payments and denials promptly while also submitting and following up on secondary claims for resolution.
• Deliver outstanding communication to clients both verbally and in writing.
• Recognize and report any issues or patterns to management as necessary.
• Work claims rejected in the claim’s clearinghouse and resubmit them as required.
• Ensure that notes are recorded within the client’s software platform in a clear, concise, and timely manner.
• Additional duties as assigned.

Revenue Cycle Analyst