communications billing analyst

California Fair Plan Association

<div><div>POSITION SUMMARY 
The Business Analyst III (Billing) is a senior IT Business Analyst with primary responsibility for leading analysis and solution direction specifically on complex insurance billing initiatives. This role ensures a tight focus on billing, payments, commissions, collections, and financial integration, bridging business needs and IT solutions at the enterprise level to enable scalable, effective billing capabilities. This position provides strategic guidance on billing system capabilities, advises on key billing solution decisions, and acts as the billing domain authority. 
 
DUTIES &amp; RESPONSIBILITIES 
<ul><li>Spearhead analysis for large and complex initiatives impacting insurance billing, payments, commissions, collections, and financial integrations</li><li>Drive end-to-end requirement lifecycle, including discovery, documentation, validation, and solution alignment for enterprise billing capabilities.</li><li>Facilitate cross-functional workshops with Billing, Finance, Product, Operations, and IT stakeholders to define and align business and system requirements.</li><li>Perform cross-system impact analysis across billing and related enterprise systems to ensure solution consistency and alignment.</li><li>Define solution approaches with architects, engineering leaders, and stakeholders.</li><li>Influence enterprise roadmap planning and contribute to billing system capability and modernization decisions.</li><li>Establish and promote analysis standards, documentation practices, and best practices across initiatives.</li><li>Provide strategic recommendations for process, system, and operational improvements in billing.</li><li>Direct complex UAT planning and execution, including coordination of defect resolution and business sign-off</li><li>Mentor and guide Business Analysts, providing functional leadership and strengthening team capability.</li><li>Act as the functional lead and trusted advisor for billing-related initiatives and decision-making discussions.</li><li>Collaborate closely with IT delivery teams, QA, and business stakeholders, ensuring successful solution delivery and adoption.</li><li>Ensure compliance with federal, state, and industry regulations impacting insurance billing.</li><li>Perform other duties as required to support organizational objectives and the successful delivery of billing initiatives.</li></ul></div><div> 
EDUCATION &amp; EXPERIENCE REQUIREMENTS 
<ul><li>A Bachelor&rsquo;s degree in Computer Science, Information Systems, Business Administration, or a related field is preferred. Equivalent combination of experience, certifications, and specialized training will also be considered.</li><li>7+ years of Business Analyst experience, with focus on insurance billing, finance, or related financial systems</li><li>Deep domain expertise in insurance billing processes, including invoicing, payments, commissions, collections, refunds, write-offs, reinstatements, and agency billing</li><li>Proven experience leading large-scale, cross-functional initiatives involving billing, policy administration, product configuration, regulatory changes, and system integrations</li><li>Strong experience working in enterprise Agile environments, including leading requirements activities, backlog management, and supporting end-to-end delivery cycles</li><li>Demonstrated ability to influence solution direction, drive alignment across stakeholders, and contribute to enterprise roadmap and capability planning discussions</li><li>Experience serving as a functional lead or trusted advisor for complex billing or financial system initiatives</li><li>Demonstrated experience mentoring and guiding Business Analysts to strengthen domain knowledge, analysis practices, and delivery effectiveness</li><li>Strong understanding of system integrations, APIs, and data flows supporting insurance policy and billing ecosystems (hands-on technical depth not required, but strong conceptual understanding expected)</li></ul></div></div>

IT Business Analyst III-Billing (Remote)

WEC Energy Group

<div>WBS, a subsidiary of WEC Energy Group, is seeking a Customer Billing Operations Analyst in our Milwaukee, Wisconsin location. This position offers flexibility for a hybrid work arrangement (remote/on-site). 
About Us 
WEC Energy Group is one of the nation&rsquo;s largest electric generation and distribution and natural gas delivery holding companies serving 4.7 million customers across the Midwest. We are committed to providing clean, reliable, and affordable energy in an environmentally sustainable manner. Customers are the heart of our business, and we work every day to help grow and support communities where we provide vital energy services. 
As a Fortune 500 company, we value and develop our employees who are making a difference in a mission that matters. We don&rsquo;t just offer a job; we provide fulfilling careers where safety and well-being are paramount. Join our team and experience first-hand our commitment to your success. We offer competitive pay and benefits to recognize your hard work and dedication. 
If you&rsquo;re talented, energetic and ready for a career with a future, we want you on our team. We are powered by a diverse and inclusive workforce fueled by the pride in what we do. If you're driven by the passion to change lives, this is the place for you.<div><div><div><h2 class="jobSectionHeader">
Job Summary</h2></div><div>
The Business Analyst (Associate/Analyst/Senior) position is responsible for providing business analyst and technical support for the Customer Services Meter to Bill Team across multiple utilities and jurisdictions. This includes performing critical controls and activities related to the Open-cIS Customer information System to ensure timely and accurate billing for customers including monthly billing rate entry/verification and Test Billing support. This role supports Meter-to-Bill operational processes, including billing accuracy, rate implementation, and system configuration within the Customer Information System. The position also applies business process and technical expertise to gather and business requirements, develop solutions, coordinate project-related activities, and author and execute test cases for system releases. Responsibilities may vary based on experience level, with senior roles providing increased leadership in requirements development, testing coordination, project support and cross-functional influence. 
This is a job family posting (Associate Business Analyst, Business Analyst, Senior Business Analyst) where the experience will determine the level offered.</div></div><div><div><h2 class="jobSectionHeader">
Job Responsibilities</h2></div><div><ul><li>
Perform analysis on large amounts of complex data to provide the business with fact-based insights.</li><li>
Provide an internal process and user/customer perspective of simplicity, efficiency, and effectiveness into design and analysis.</li><li>
Support departmental reporting, metrics, budgets, dashboards, and analytics.</li><li>
Make recommendations and present alternatives to address business needs or resolve impediments.</li><li>
Perform system configuration and administration within the Customer Information System</li><li>
Develop functional, process, and system documentation.</li><li>
Monitor system and process performance and escalate issues as appropriate.</li><li>
Influence stakeholders and gather, define, and document complex business requirements and processes.</li><li>
Serve as subject matter expert on systems, process, and user/customer impact.</li><li>
Identify change management implications of business processes and system changes.</li><li>
Support billing accuracy by assisting with rate implementation, validation, and testing within the Customer Information System.</li><li>
Support project initiatives by gathering, defining, and coordinating business requirements, developing and maintaining project plans or tracking templates, coordinating testing activities, and supporting implementation and release tasks across business and technical teams.</li><li>
Support system releases by coordinating testing activities, validating results, and assisting with defect tracking and resolution.</li></ul></div></div><div><div><h2 class="jobSectionHeader">
Minimum Qualifications</h2></div><div><ul><li>
Bachelor's Degree in Business Administration, Information System/Technology or related discipline (May 2026 grads eligible to apply)</li><li>
Strong analysis, decision making and problem solving skills</li><li>
Excellent interpersonal and communication skills (both written and verbal)</li><li>
Ability to work as part of a team and interact effectively with others</li><li>
Excellent organizational skills with the ability to balance multiple tasks under time constraints</li><li>
Experience working with project management methodology preferred</li><li>
Proficient in standard office software (MS Excel, Visio, Word)</li></ul></div></div><div><div><h2 class="jobSectionHeader">
Preferred Qualifications
</h2></div><div><ul><li>2+ years&rsquo; experience with SQL Server.</li><li>
Experience with Power BI or similar data visualization and reporting tools.</li><li>
Experience working with large datasets and performing data analyses to support business decisions.</li><li>
Knowledge of utility billing processes and Meter-to-Bill operations.</li><li>
Strong analysis, decision-making and problem-solving skills.</li><li>
Excellent interpersonal and communication skills (both written and verbal).</li><li>
Ability to work as part of a team and interact effectively internally or virtually with others.</li><li>
Excellent organizational skills with the ability to balance multiple tasks under time constraints.</li><li>
Experience working with Customer Information Systems or utility billing systems.</li><li>
Experience supporting project management activities, including gathering and documenting business requirements, developing project plans or tracking templates, coordinating testing activities, and supporting implementation and release efforts.</li><li>
Ability to work effectively in a complex and evolving operational environment.</li><li>
Proficient in standard office software (MS Excel, Word, and PowerPoint).</li></ul></div></div></div>
End Date: 04/23/2026 
Pay Range Minimum: $68,436.68
Pay Range Maximum: $135,761.08 
The pay range reflects the minimum and maximum for the position at the time of posting and may be modified in the future. The starting salary/pay within the pay range will be based on several factors, as applicable, but not limited to, relevant education, qualifications, certifications, experience, skills, geographic location, shift, travel requirements, collective bargaining agreements, and business and organizational needs. At WEC Energy Group, it is not typical for an individual to be hired at or near the top of the range for their role. 
WEC Energy Group benefits
We reserve the right to modify the application deadline or discontinue accepting applications for any position if deemed necessary. 
WEC Energy Group will only employ those who are legally authorized to work in the United States. Individuals with temporary visas such as E, F-1 with OPT or CPT, H-1, H-2, L-1, B, J or TN, or who need sponsorship for work authorization now or in the future, are not eligible for hire. 
WEC Energy Group and its subsidiaries are Equal Opportunity Employers. As a result, all qualified applicants will receive equal employment opportunity without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, protected veteran status or any other protected status. The Company also complies with all applicable federal, state and local laws that require it to take affirmative action. 
EEO/AA policies and statements</div>

Customer Billing Operations Analyst

Norton Healthcare

<div>Responsibilities:
<div>
The Revenue Cycle Analyst acts as the subject matter expert in payor reimbursements and medical policies, while supporting the revenue cycle functions of the organization. This includes, but is not limited to, preparing and forwarding patient claims to appropriate third-party payors, analyzing and reviewing claims to ensure compliance with payor specific requirements, following up on outstanding claims and performing billing and collections activities that directly influence meeting metric goals (e.g. cash, denial rates and days in AR). The Revenue Cycle Analyst also identifies patterns and trends with payors, as well as internal processes, to recommend and implement process improvements, while ensuring leadership&rsquo;s awareness and alignment.</div><div></div><div> 
**This position offers a fully remote work opportunity. Employees in this role must reside in one of the following states to be considered for fully remote positions: Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina**</div>
Qualifications:
<div>
Required:</div><ul><li><div>
With Associate's degree, one year of Revenue Cycle experience</div></li><li><div>
Without Associate's degree, three years of Revenue Cycle experience</div></li></ul><div>
Desired:</div><ul><li><div>
Associate's Degree</div></li></ul></div>

Revenue Cycle Analyst, Billing, Days, Fully Remote

South Central Regional Medical Center

<div>Epic Billing Claims &amp; Electronic Remittance Analyst &ndash; Job Description
Position Summary
The Epic Billing Claims and Electronic Remittance Analyst is responsible for the design, build, optimization, and support of Epic Revenue Cycle functionality related to claims submission, remittance advice (ERA), and payer connectivity. This role partners closely with Revenue Cycle, Patient Financial Services, IT, and external payers to ensure accurate, timely billing and reimbursement while supporting continuous optimization and regulatory compliance.
Application Build &amp; Configuration<ul><li>
Configure, support, and optimize Epic Billing Claims, Electronic Remittance (ERA), and related Revenue Cycle workflows.</li><li>
Build and maintain claim formats, payer edits, remittance routing, adjustment reason codes and posting logic.</li><li>
Support clearinghouse integrations and payer connectivity.</li><li>
Configure and troubleshoot ANSI X12 transactions (837, 835, 276/277, 999).</li><li>
Maintain payers-specific rules, claim edits, and remittance mapping.</li></ul>
Claims &amp; Remittance Operations<ul><li>
Troubleshoot claim rejections, denials and remittance posting issues.</li><li>
Analyze payer responses and identify root causes of claim failures or posting discrepancies.</li><li>
Support electronic payment posting, secondary billing and reconciliation processes.</li><li>
Partner with billing and follow-up teams to improve first-pass claim acceptance and payment accuracy.</li></ul>
Optimization &amp; Reporting<ul><li>
Participate in optimization initiatives to improve claims throughput, reimbursement accuracy and cash flow.</li><li>
Analyze workflows and recommend system enhancements aligned with Epic best practices.</li><li>
Develop and maintain reports and dashboards related to claims status, remittance posting and payer performance.</li><li>
Support system upgrades, patches and new Epic functionality related to billing and remittance.</li></ul>
Collaboration &amp; Governance<ul><li>
Collaborate with operational stakeholders, payers, clearinghouses, and vendor partners.</li><li>
Participate in governance groups, optimization committees, and project workgroups.</li><li>
Assist with testing (unit, integrated, and user acceptance testing) for Revenue Cycle changes.</li><li>
Provide end-user training, documentation, and ongoing support.</li></ul>
Compliance &amp; Quality<ul><li>
Ensure Epic build and workflows comply with regulatory requirements (CMS, HIPAA, payer rules).</li><li>
Support audits related to billing, claims, and remittance processing.</li><li>
Follow change management and documentation standards.</li></ul>
Qualifications
Required<div><ul><li>
Bachelor&rsquo;s degree in Information Systems, Business, Healthcare Administration, or a related field; or equivalent experience.</li><li>
1&ndash;3+ years of Epic experience preferred (Hospital Billing, Professional Billings, Claims, and Remittance).</li><li>
Hands-on experience supporting revenue cycle with focus on claims and electronic remittance.</li><li>
Understanding of healthcare billing workflows and payer interactions.</li><li>
Knowledge of EDI transactions (837, 835) and remittance processes.</li></ul></div><ul><li>
Strong analytical, problem‑solving, and troubleshooting skills.</li><li>
Excellent communication and customer service abilities.</li></ul>
Preferred<ul><li>
Epic certification in Billing or willingness to obtain within 90 days.</li></ul>
Competencies<ul><li>
Ability to translate billing workflows into technical Epic configuration.</li><li>
Strong attention to detail and commitment to documentation accuracy.</li><li>
Ability to work both independently and collaboratively with clinical teams.</li><li>
Strong organization, time management, and prioritization skills in a fast‑paced environment.</li><li>
Discretion and ability to manage PHI and sensitive patient information.</li><li>
Experience with Epic Hyperspace, Reporting Workbench, SmartTools, or clinical decision support is a plus.</li></ul>
Work Environment<ul><li>
Standard office environment with hybrid or in‑office options based on organizational policy.</li><li>
Occasional after‑hours or on‑call support during upgrades, go‑lives, and critical clinical workflows.</li></ul></div>

BILLING CLAIMS & ELECTRONIC REMITTANCE ANALYST

Quest Diagnostics

<div>Business Analyst - Billing - Monday to Friday, 8:30 AM to 5:00 PM Eastern
Pay range: $66,550 - $100,000 / year
Salary offers are based on a wide range of factors including relevant skills, training, experience, education, and, where applicable, certifications obtained. Market and organizational factors are also considered. Successful candidates may be eligible to receive annual performance bonus compensation. 
Benefits information: 
We are proud to offer best-in-class benefits and programs to support employees and their families in living healthy, happy lives. Our pay and benefit plans have been designed to promote employee health in all respects &ndash; physical, financial, and developmental. Depending on whether it is a part-time or full-time position, some of the benefits offered may include:<ul><li>
Day 1 Medical, supplemental health, dental &amp; vision for FT employees who work 30+ hours</li><li>
Best-in-class well-being programs</li><li>
Annual, no-cost health assessment program Blueprint for Wellness&reg;</li><li>
healthyMINDS mental health program</li><li>
Vacation and Health/Flex Time</li><li>
6 Holidays plus 1 &quot;MyDay&quot; off</li><li>
FinFit financial coaching and services</li><li>
401(k) pre-tax and/or Roth IRA with company match up to 5% after 12 months of service</li><li>
Employee stock purchase plan</li><li>
Life and disability insurance, plus buy-up option</li><li>
Flexible Spending Accounts</li> 
<li>
Matching gifts program</li><li>
Education assistance through MyQuest for Education</li><li>
Career advancement opportunities</li><li>
and so much more!</li></ul><div>
<div><div><div>Quest Diagnostics honors our service members and encourages veterans to apply. 
 
While we appreciate and value our staffing partners, we do not accept unsolicited resumes from agencies. Quest will not be responsible for paying agency fees for any individual as to whom an agency has sent an unsolicited resume. 
 
Equal Opportunity Employer: Race/Color/Sex/Sexual Orientation/Gender Identity/Religion/National Origin/Disability/Vets or any other legally protected status.</div>
</div> 
</div></div><ul><li>Assesses and interprets customer needs and requirements</li><li>
Serves as a key resource on complex and/or critical issues</li><li>
Solves complex problems, conducts complex analysis and develops innovative solutions</li><li>
Works with minimal guidance</li><li>
Translates concepts into practice</li><li>
Reviews work performed by others and provides recommendations for improvement</li><li>
Provides explanations and information to others on complex issues</li><li>
Coaches, trains, provides feedback, and guides others</li><li>
Acts as a resource for others with less experience</li><li>
Analyzes, creates data insights and reports on performance of systems and processes</li><li>
Manages and maintains process documentation, including creating new, reviewing existing and revising all process documentation for the contact center.</li><li>
Leads functional or segment teams or projects</li></ul>
Required Qualifications:<ul><li>
High School Diploma / GED (or higher)</li><li>
Undergraduate degree or equivalent experience</li><li>
5+ years of Revenue cycle and / or medical billing experience</li><li>
3+ years of experience in business / finance analysis</li><li>
Solid knowledge of the lab billing system</li><li>
Demonstrated ability to manage multiple responsibilities in complex environment</li><li>
Working knowledge of insurance reimbursement, medical terminology, ICD-10, CPT and HCPCS coding</li><li>
Intermediate level of proficiency with PC-based software programs and automated database management systems (Excel, Access, PowerPoint)</li><li>
Demonstrated ability to problem solve including multiple priorities and research of conflicting and / or inaccurate data</li><li>
Excellent interpersonal, written, and verbal communication skills</li><li>
Intermediate level of knowledge in process documentation management</li></ul> 
Preferred Qualifications:<ul><li>
Ability to probe, analyze, synthesize, and articulate complex subject matter so it can be easily understood</li><li>
A high degree of self-motivation, versatility, and flexibility</li><li>
Proven track record for improving process efficiencies and solving problems</li><li>
Excellent presentation, analytical and problem-solving skills</li><li>
Ability to manage multiple projects concurrently</li><li>
Ability to communicate analysis including trends and opportunities in writing and verbally</li></ul></div>

Business Analyst - Billing

CATHOLIC CHARITIES EASTERN WASHINGTON

<div>Not a remote job. Regular in-person attendance is required for this position to effectively perform job duties. 
WE OFFER EXCELLENT BENEFITS:
<ul>
<li>FREE Employee Medical Insurance</li>
<li>FREE Employee Dental Insurance</li>
<li>FREE Employee Vision Insurance</li>
<li>Sick leave (8 hours per month)</li>
<li>Vacation (Minimum of 2 weeks paid vacation)</li>
<li>Discounted health memberships</li>
<li>Retirement (Employer contribution - 3% contribution and an additional 3% employer match)</li>
<li>FREE Long-Term Disability Insurance</li>
<li>FREE Life Insurance</li>
<li>13 Paid Holidays</li></ul> 


Mission of Catholic Charities

Feed the hungry, heal the hurting, welcome the stranger. 
CCEW is an equal opportunity employer. All employees and potential employees will be recruited, selected, trained, promoted, compensated and, if necessary, disciplined or terminated without regard to sex, gender, race, ethnicity, national origin, citizenship, immigration status, religious affiliation, marital status, military veteran status, age, pregnancy, sexual orientation, gender expression or identity, disability, genetic information, or any other basis protected by law. 
Job Summary

This position is responsible for support of the finance department and the administration of billing functions for various contracts, medical billings, and St. Anne&rsquo;s Child &amp; Family Center 
Job Duties/Responsibilities

To perform this job successfully, an individual must be able to satisfactorily perform each of the essential duties/responsibilities listed below. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties/responsibilities of this job. This job may include any of the responsibilities listed below.<div> 
<ul><li>
Prepares and submits monthly contract billings including but not limited to Medicaid, Special Mobility, and (FCS) Foundational Community Supports programs, and other related fee for service contracts, that are administered in different programs across the agency.</li></ul>
<ul><li>Prepares accurate invoices for reimbursement, claim generation and submission. Extract and upload billing information to and from Sales Force. Review electronic health records for coding accuracy and compliance with contracts and/or billing procedure manuals. Work with program staff to identify and resolve any coding issues or discrepancies prior to billing submission.</li></ul>
<ul><li>Identifies and resolves associated billing questions and issues. Reconciles insurance remittances and payments, research claim denials and generates claim corrections. Communicate issues with Program Manager or Director as necessary.</li></ul>
<ul><li>Sends reminders for payments and manages delinquent accounts.</li></ul>
<ul><li>Prepare monthly billing submissions and attend various oversight meetings for contracts and grants as needed.</li></ul>
<ul><li>Performs all bookkeeping &amp; billing functions for St. Anne&rsquo;s Child &amp; Family Center.</li></ul>
<ul><li>Assists with the preparations for the annual audit and other Finance Department activities as required.</li></ul>
<ul><li>Uses appropriate administrative, fiscal, physical, and technical safeguards to ensure the confidentiality, integrity, and security of CCEW client protected health information (PHI), per regulations outlined in the Health Insurance Portability and Accountability Act of 1996 (HIPAA).</li></ul>
<ul><li>Regularly utilizes all forms of communication (email, text, phone, etc.) and database practices necessary for this position and as directed by supervisor.</li></ul>
<ul><li>As a mandated reporter, follows all procedures outlined in agency policies and procedures to report to the proper agency when there is suspicion and/or confirmation that a child or adult has been a victim of abuse or neglect.</li></ul>
<ul><li>Other duties as assigned.</li></ul>
<ul><li>Adheres to the tenants of the Catholic Social Teaching and Catholic Doctrine.</li></ul>
<ul><li>Perform as a team member to ensure that productivity outcome measures are achieved.</li></ul>
<ul><li>Performs related functions necessary to support the mission and core values of Catholic Charities.</li></ul></div> 


Job Qualifications

To perform this job successfully, an individual must meet the minimum qualifications listed below. These qualifications are representative of the knowledge, skill and/or ability required to perform this job. 
Education/Experience: 
to perform this job successfully, an individual must have: AA in accounting field or equivalent experience. Experience or certification in medical office and billing procedures preferred but not required. Knowledge and/or experience in data systems and report management. Experience in office management and billing behavioral health or medical services. Ability to learn software programs and EHR systems. 
Certificates/Licenses: Successfully pass background check applicable to position. 
Physical Abilities: To perform this job successfully, an individual must be able to:
<ul>
<li>Regularly sit, stand, climb, walk, hear/listen, talk</li>
<li>Frequently 
lift up to 25 pounds, pull/push, carry, grasp, reach</li>
<li>Occasionally crawl, stoop, kneel 
</li>
<li>Clearly see 20+ feet, with or without corrective lenses, ability to focus</li></ul> 


Mental &amp; Other Skills/Abilities: To perform this job successfully, an individual must have the:
<ul>
<li>Adaptability: ability to adapt to changes, delays or unexpected events in the work environment; ability to manage competing demands and prioritize tasks; ability to change approach or method to best fit the situation.</li>
<li>Analytical Ability: ability to maintain focus for extended periods of time; ability to complete research projects with resourcefulness and persistence; ability to synthesize complex or diverse information; ability to use intuition and experience to complement existing data.</li>
</ul><ul><li>Attendance: ability to consistently arrive and be able to work as scheduled.</li>
</ul><ul><li>Computer/Technical Ability: 
working knowledge of Word Processing software, Spreadsheet software, Accounting software, Internet software.</li>
<li>Dependability: ability to follow instructions, both in written and verbal format; ability to respond to management direction; ability to complete tasks on time or notify the appropriate person with an alternate plan when necessary.</li>
<li>Interpersonal Skills: ability to maintain satisfactory relationships with others, excellent customer service skills and a good overall understanding of appropriate human relations. Awareness of and sensitivity to the service population&rsquo;s culture and socioeconomic characteristics.</li>
<li>Judgment: ability to make prudent and timely decisions; ability to exhibit sound and accurate judgment; ability to explain reasoning for decisions.</li>
<li>Language Ability: ability to read and comprehend simple instructions, short correspondence, and memos. Ability to write simple correspondence; ability to effectively present information in one-on-one and small group situations to customers, clients, and other employees of the organization.</li>
<li>Mathematical Ability: ability to calculate figures and amounts such as discounts, interest, commissions, proportions, percentages, area, circumference, and volume; ability to apply concepts of basic algebra and geometry.</li>
<li>Motor Coordination: the ability to coordinate eyes, hands, fingers, and feet accurately and handle precise movements.</li>
<li>Problem Solving Ability: ability to identify and/or prevent problems before they occur; ability to formulate alternative solutions to problems when necessary; ability to transfer learning from past experiences to new experiences of similar nature.</li>
<li>Quality Management: ability to complete duties, on time and with absolute precision, maintain between 92%-96% accuracy; ability to edit the accuracy and thoroughness of one&rsquo;s work as well as the work of others; ability to constructively apply feedback to improve performance, ability to generate ideas to improve and promote quality in work.</li>
<li>Reasoning Ability: ability to apply common sense understanding to carry out instructions furnished in written, oral, or diagram form; ability to deal with problems involving several concrete variables in standardized situations.</li>
<li>Supervisory Skills: 
this job has no direct supervisory responsibilities.</li></ul> 


Workplace Environmental Conditions

While performing the essential duties/responsibilities of this job, the employee will be:
<ul>
<li>Noise Conditions: exposed during a shift to constant or intermittent sounds at quiet to moderate levels of sound dependent upon daily activities.</li></ul></div>

Billing & Contracts Analyst

Parallon

<div>Introduction
This Work from Home position requires that you live and will perform the duties of the position; within 60 miles of an HCA Healthcare Hospital (Our hospitals are located in the following states: FL, GA, ID, KS, KY, MO, NV, NH, NC, SC, TN, TX, UT, VA).
Are you passionate about the patient experience? At HCA Healthcare, we are committed to caring for patients with purpose and integrity. We care like family! Jump-start your career as a(an) Billing Integrity Analyst Credentialed today with Parallon.
Benefits
Parallon offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:
<ul><li>Comprehensive medical coverage that covers many common services at no cost or for a low copay. Plans include prescription drug and behavioral health coverage as well as free telemedicine services and free AirMed medical transportation.</li><li>
Additional options for dental and vision benefits, life and disability coverage, flexible spending accounts, supplemental health protection plans (accident, critical illness, hospital indemnity), auto and home insurance, identity theft protection, legal counseling, long-term care coverage, moving assistance, pet insurance and more.</li><li>
Free counseling services and resources for emotional, physical and financial wellbeing</li><li>
401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service)</li><li>
Employee Stock Purchase Plan with 10% off HCA Healthcare stock</li><li>
Family support through fertility and family building benefits with Progyny and adoption assistance.</li><li>
Referral services for child, elder and pet care, home and auto repair, event planning and more</li><li>
Consumer discounts through Abenity and Consumer Discounts</li><li>
Retirement readiness, rollover assistance services and preferred banking partnerships</li><li>
Education assistance (tuition, student loan, certification support, dependent scholarships)</li><li>
Colleague recognition program</li><li>
Time Away From Work Program (paid time off, paid family leave, long- and short-term disability coverage and leaves of absence)</li><li>
Employee Health Assistance Fund that offers free employee-only coverage to full-time and part-time colleagues based on income.</li></ul>
Learn more about Employee Benefits
Note: Eligibility for benefits may vary by location.
Come join our team as a Billing Integrity Analyst Credentialed. We care for our community! Just last year, HCA Healthcare and our colleagues donated $13.8 million dollars to charitable organizations. Apply Today!
Job Summary and Qualifications
The Billing Integrity Analyst (credentialed) is responsible for determining the appropriateness of patient charges, and Charge Description Master (CDM) assigned HCPCS/CPTs, by reviewing the medical record, facility protocol, and other applicable documentation. This review includes the verification of billing data for accuracy and completeness, following regulatory requirements, in order to resolve edits or exceptions detected during system processing of the claim in Patient Accounting, Relay Health or the payer. Applies modifiers when appropriate based on this review, and/or makes necessary adjustments to patient account charges and/or balances. Analyzes accounts for specialized billing requirements that require a review of the medical record documentation, regulatory information, and HCA standards. Combines or splits accounts as appropriate. Serves as a liaison between facilities Administration, Shared Services Center, and ancillary department directors regarding charging issues, clinical documentation issues and revenue opportunities. Provides charge review results and develops and coordinates educational in-services for facility staff related to charging/billing issues. Coordinates retrospective, concurrent, patient requested, and external billing audits. Reviews denial trends for documentation and charging opportunities. Serves as a primary contact for charge related SSC and facility inquiries and issues.
In this role you will:
<ul><li>Analyze and resolve specific billing edits that require HCPCS/CPT coding based on the chargemaster expertise and that are delaying claims from processing in the Patient Accounting and/or Relay Health systems. This includes the verification (and/or correction) of billing data for accuracy and completeness, by following regulatory requirements, and reviewing the medical record, facility protocol, and other applicable documentation. This also includes the application of modifiers and condition codes, as appropriate.</li><li>
Identify charging, chargemaster coding, or clinical documentation issues and work with appropriate leadership and ancillary departments to resolve issues that are identified while working on edits.</li><li>
Serve as charge master liaison to facilitate clinical department education on appropriate charging of CPT codes, Revenue Codes, and communicating with Ancillary Departments to resolve issues. Coordinates updates (activate, inactivate, modification) with Ancillary Departments as necessary</li><li>
Review Regulatory and Compliance Communications, applicable CMS transmittals, and Local Coverage Decisions (LCD). Assess impact to Billing Integrity procedures and implement changes as needed.</li><li>
Maintain billing education, attend webcasts and conference calls as required.</li></ul>
Qualifications:
<ul><li>Associate Degree or above; or healthcare license/certification required.</li><li>
Minimum 1 year directly related Healthcare experience or coding experience required.</li><li>
Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews preferred.</li><li>
Healthcare certification/licensure such as RHIT, CCS, CCP,CPC or other recognized AHIMA certified coding credential, LPN, LVN, RT, PT, etc., can be accepted lieu of degree with work experience.</li></ul>
Parallon provides full-service revenue cycle management, or total patient account resolution, for HCA Healthcare. Our services include scheduling, registration, insurance verification, hospital billing, revenue integrity, collections, payment compliance, credentialing, health information management, customer service, payroll and physician billing. We also provide full-service revenue cycle management as well as targeted solutions, such as Medicaid Eligibility, for external clients across the country. Parallon has over 17,000 colleagues, and serves close to 1,000 hospitals and 3,000 physician practices, all making an impact on patients, providers and their communities.
HCA Healthcare has been recognized as one of the World&rsquo;s Most Ethical Companies&reg; by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses. 
 
 
&quot;The great hospitals will always put the patient and the patient's family first, and the really great institutions will provide care with warmth, compassion, and dignity for the individual.&quot;- Dr. Thomas Frist, Sr. 
HCA Healthcare Co-Founder
If you are looking for an opportunity that provides satisfaction and personal growth, we encourage you to apply for our Billing Integrity Analyst Credentialed opening. We promptly review all applications. Highly qualified candidates will be contacted for interviews. Unlock the possibilities and apply today!
We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.</div>

Billing Integrity Analyst Credentialed

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