Jobs in Franklin, TN

About the role

The Resolution Analyst acts as the liaison between key client contacts and our denials and underpayment appeal process to the appropriate payer. The Resolution Analyst is responsible for facilitating payment review recovery efforts for denied and underpaid accounts for assigned clients, thereby increasing the departments revenue. This position is responsible for handling patient health information (PHI) and maintaining extreme privacy and security as it relates to confidential and proprietary information.

What you'll bring

• High School Diploma or GED required.
• 5+ years’ experience in healthcare field working in billing or collections.
• 1+ years’ client facing/customer services experience.
• Intermediate level understanding of insurance payer/provider claims processing and subsequent data requirements.
• Equivalent combination of education and experience will be considered.
• Must have strong computer proficiency and understand how to use basic office applications, including MS Office (Word, Excel, and Outlook).
• Strong understanding of the revenue cycle process.
• Full understanding of hospital reimbursement, Intermediate knowledge of Managed Care contracts, Contract Language, and Federal and State requirements.
• Familiarity with HMO, PPO, IPA, and capitation terms and how these payors process claims.
• Intermediate understanding of EOB, hospital billing form requirements (UB04), and familiarity with the HCFA 1500 forms.
• Demonstrate strong ability to review client/payer contracts to identify complex underpayments.
• Regular and predictable attendance.

Locations