BASF

Senior Healthcare Reclamation Analyst

BASF

full-time

Posted on:

Location Type: Remote

Location: United States

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Salary

💰 $54,000 - $64,000 per year

Job Level

Senior

About the role

  • Leverage knowledge and expertise in COB/TPL/Recovery to gather and review in-house data with payer correspondence to determine proper order of benefits and resolve primacy issues.
  • Successfully solve complex data or record discrepancies and/or issues.
  • Communicate effectively with carriers to determine primacy; answer questions and/or provide information that will bring to successful payment or other appropriate account action.
  • Contact Healthcare Insurance carriers regarding claim responses.
  • Educate Healthcare Insurance carriers on the Coordination of Benefits rules and appropriately respond to complex questions.
  • Analyze and understand written communication from insurance companies including explanation of benefits (EOBs).
  • Actively collaborate with internal groups and/or functions with gathering and interpretation of the claims billing process and denial management for continuous improvement in workflow and systems.
  • Actively contribute to continuous improvement and development for new client programs of scripts, guidelines, and other tools provided to have professional conversations with Healthcare Insurance carriers and/or providers.
  • Effectively work assigned inventories to consistently exceed productivity metrics assigned by management, while also performing other duties of the senior analyst role that support the broader group.
  • Leverage knowledge and expertise to research various scenarios that will bring to successful resolution and payment and consistently resolve the most complex eligibility discrepancies and questions.
  • Initiate applicable action and documentation based upon insurance carriers selected.
  • Update company systems with clear and accurate information such as point of contact, updated demographic information, notes from contact from outbound and inbound calls and/or attempts, as well as account status updates as applicable.
  • Support management with inventory assessment and distribution to team members.
  • Provide ongoing feedback to Management and Analytics Teams to further the enhancement of products and services, workflows, and documentation.
  • Assist Management on assigned projects (including ramping up new client programs), client requests, regular reporting, data analysis and reconciliations, testing, and analytics reviews as required by the business.
  • Serve as a mentor/subject matter expert to representative and junior analyst team members to maximize their potential throughout their development process and lead by example.
  • Conduct quality reviews on work performed by team representatives and analysts on the team as requested by management.
  • Support team training activities and contribute to development and enhancement of training materials and tools.
  • Lead and contribute to ad-hoc projects and initiatives and establishing best practices.

Requirements

  • High School diploma or GED; college preferred: equivalent combination of education and related experience.
  • Minimum 4 years of directly related progressive experience (billing reclamation, recovery, eligibility, etc.), including Coordination of Benefits, Third Party Liability, and/or Reclamation, demonstrating depth and breadth of knowledge and capability required for the position.
  • Minimum 1 year of experience in a function demonstrating the ability to lead or make strong contributions to initiatives involving operations workflow, data reporting and analysis, contributing to the set-up of new clients or programs, or subject matter expertise applied to department workflows or projects, direct or indirect staff oversight or training, etc.
  • Demonstrated experience gathering, researching, interpreting, and documenting data and requirements for projects and/or complex problem solving.
Benefits
  • medical
  • dental
  • vision
  • HSA/FSA options
  • life insurance coverage
  • 401(k) savings plans
  • family/parental leave
  • paid holidays
  • paid time off annually
Applicant Tracking System Keywords

Tip: use these terms in your resume and cover letter to boost ATS matches.

Hard Skills & Tools
COBTPLRecoverydata analysisbilling reclamationeligibilityCoordination of BenefitsThird Party Liabilitydocumentationdata reporting
Soft Skills
communicationcollaborationproblem solvingmentoringleadershiptrainingquality reviewfeedbackcontinuous improvementorganizational skills