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Claims Analyst Role

STAT Revenue is seeking a detailed and analytical individual to conduct research on potentially underpaid hospital claims and escalate appropriately to ensure proper reimbursement. This includes reviewing claims for contractual, coding, and clinical accuracy, correctly applying complex contractual language, and extensive communication with insurance companies by phone and written letters. The ideal candidate has the ability to learn or already has experience with hospital reimbursement and claims.

Other responsibilities include:

  • Compile and research information from multiple sources (hospital systems, internal software, payer and government websites)
  • Apply contract language to calculate correct payment to the hospital
  • Navigate customer service phone trees
  • Gather information from phone calls
  • Document work in internal and external systems
  • Write appeals or escalate next steps as deemed appropriate

Skills:

  • Demonstrated ability to conduct internet research
  • Detail-oriented
  • Ability to interact with customer service representatives in a persistent and professional manner
  • Strong research and critical thinking skills
  • Flexible and able to work across multiple systems and projects
  • Ability to apply complicated calculations and formulas
  • Ability to comprehend contract language, government publications, medical records, and other formal documents
  • Ability to write succinct and clear notes and formal appeal letters
  • Analytical with ability to identify issues and problem solve independently

Desired Qualifications:

  • Experience reviewing hospital claims
  • Experience with the hospital revenue cycle
  • Experience calling insurance companies and using hospital or payer claims systems
  • Experience with managed care contracts and hospital reimbursement

Contact Information: recruiting@statrevenue.com
Required documents for application: Submit your resume and cover letter with “STAT Rebiller” in the subject line via email or the form below.

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