Payor Analyst

Job Description

You could say Brightree by ResMed is a technology company. And that's true. But Brightree is, at its heart, about people. We develop innovative, end-to-end technology solutions and services for people facing everyday challenges in the post-acute care industry. Brightree helps streamline processes, improve efficiency, and increase profitability. For over fifteen years, organizations big and small have put their trust in us-for our wide-ranging solutions, our leadership, and our unmatched customer service. Going to work each day and creating new ways to positively impact our customers' businesses and the lives of patients is just what we do. Because Brightree is, after all, about people.

To learn more about Brightree technology and solutions watch this short video by our CEO:

Please note we plan to hire for this role in the near future, applications to this job posting are to express interest in possible future openings (there is not a current role open). Due to this being an expression of interest, there may be a delay in hearing back from our recruiting team.
Payor Analyst is responsible for financial results of the insurance companies and Brightree customers. In addition, this role is, responsible for identifying and following policies, procedures and systems for quality assurance as directed by Medicare, Medicaid and Private insurance. Create and revise our
standard operating procedures and educate our partners, vendors, and internal teams on those procedures. Responsible for quality assurance of work performed by internal team members.

Let's talk about responsibilities:

  • Understanding all general rules, guidelines, and methods to get paid from the insurance companies for which they are assigned
  • Responsible for the financial results of the insurance companies and Brightree customers by ensuring accuracy: reducing credit adjustments and write offs
  • Maintaining and communicating payor specific account receivables and standard operating procedures are updated with the most current information
  • Propose changes and updates to the configuration of the customers Brightree system including but not limited to:
- Price tables
- Insurance Settings
- Modules adoption
- Additional Services
  • Identifying areas of opportunities to better streamline internal or external processes
  • System Enhancements to the Brightree System Process improvements to increase efficiency
  • Prepares and submits reports to team lead as needed including but not limited to:Quality Assurance Reporting Denial Analyst Reporting
  • Service Level Agreement Reporting
  • Ensures adherence to objectives, operating policies and procedures, and strategic action plans for achieving goals
  • Maintains patient confidentiality and function within the guidelines of HIPAA

Let's talk about experience:
  • 2-year degree required; college coursework a plus; equivalent combination of education and experience will be considered
  • Minimum of 2 years of accounts receivable in healthcare billing
  • Minimum of 2 years experience working in & maintaining HIPAA standards
  • Highly skilled in using computers & Microsoft products is required
  • Highly motivated in billing, claims, denials and document management to work with our internal and external customers on the phone, via software applications and via email.
  • Passionate about customer service
  • Strong problem-solving skills focused on identifying and putting in place solutions for internal and external customers
  • An effective communicator with strong oral, written and persuasive skills and capability to deal with people at all levels in the organization.
  • Exceptional organizational skills with a high level of attention to detail and the ability to multitask
  • Self-starter, results driven, highly motivated, high energy
  • Proven track record of working towards and exceeding metrics strongly preferred

Joining us is more than saying "yes" to making the world a healthier place. It's discovering a career that's challenging, supportive and inspiring. Where a culture driven by excellence helps you not only meet your goals, but also create new ones. We focus on creating a diverse and inclusive culture, encouraging individual expression in the workplace and thrive on the innovative ideas this generates. If this sounds like the workplace for you, apply now!

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