HMO Reimbursement Analyst
hace 4 días
Role Overview:
We are seeking an HMO Reimbursement Analyst to join our team. The ideal candidate will have a strong understanding of insurance regulations and reimbursement rules.
About the Role:
The HMO Reimbursement Analyst will be responsible for reviewing and interpreting insurance policies, coding guidelines, and reimbursement rules to identify patterns in claims denials or payment discrepancies.
Key Responsibilities:
Review and interpret insurance policies, coding guidelines, and reimbursement rulesIdentify patterns in claims denials or payment discrepanciesConduct root cause analysis and develop strategies to optimize reimbursementCommunicate with insurance companies and provide additional documentation or informationMaintain proper documentation of all insurance-related activities and ensure compliance with regulatory requirementsRequirements:
To be successful in this role, you will need strong analytical skills to review and interpret insurance policies, coding guidelines, and reimbursement rules.
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Hmo Biller
hace 2 semanas
Panamá, Panamá Insignia Resources A tiempo completoVerify patients' insurance coverage, recode, and resubmit claims electronically or via paper forms, and ensure that all necessary documentation is attached. - Verify patients' insurance coverage and eligibility by contacting insurance companies, reviewing insurance plans, and obtaining necessary authorizations or referrals. - Monitor the status of claims,...
