PDS Health
Associate Analyst, Revenue Operations
PDS Health, Irving, Texas, United States, 75084
Now is the time to join PDS Health. You will have opportunities to learn new skills from our team of experienced professionals. If you're ready to take your career to the next level and gain valuable experience, apply today!
The primary function of the Associate Analyst, Revenue Operations is to effectively assist in production and collections. This individual works closely with the Analyst, Collections II and assists on action plans developed for opportunities identified. The Associate Analyst, Revenue Operations ensures that claims are properly billed to the patients and insurance companies and ultimately paid. This position is proactive in its efforts to ensure insurance companies are billed correctly and promptly, as well as receivables are collected effectively in each office.
Responsibilities
Assist Analyst, Revenue Operations to maximize office collections, communicate issues and implement guidelines/parameters to improve processes.Analyze various internal and external reports to review/trace outstanding and complex claim payments, request additional information from practices, make claim corrections, re-submit, and appeal with carriers for proper payment.Assist in identifying strategic financial solutions for Regional Manager (RM) and Operations Manager (OM) to drive higher percentage of payments, faster billing cycles and top line revenue.Analyze the AR Metrics to identify offices that need training or billing process improvements.Identify opportunities and present to Collections Analyst II to work with regions on best practices and more efficient billing processes.Perform daily activities of auditing and billing of assigned practice's patient claims to ensure accurate and maximum reimbursement for patient treatment from insurance carriers.Analyze Explanation of Benefits (EOB) statements and adjust accounts according to PDS claims processing criteria.Identify necessary adjustments to accounts and use negotiation skills to obtain claims approval and payment information from various carriers.Review and examine AR Report to ensure accounts are properly billed to the insurance.Weekly, check the portals (e.g. Request for Information (RI), and Claims Portal) to ensure that any missing information is obtained, so that the claims are billed properly and claims are properly adjudicated.Partner with Analyst II, Collections to provide feedback around maximizing the collectable revenue for the region/office.Communicate trends and suggestions to improve processes to Collections Analyst II.Other duties as assigned by management.Required
Bachelor's Degree in Finance, Business Administration or related field. In lieu of degree, 1+ years of claims auditing or related experience is required.Experience working with QSI (Quality Systems Inc.).Strong computer and data entry skills with competent knowledge of Microsoft Word, Outlook and Excel software applications.Preferred
Previous Operation Management experience in with a retail store or medical/dental practice.Insurance Claims Auditing experience.Benefits
Medical, dental, and vision insurancePaid time offTuition Reimbursement401KPaid time to volunteer in your local community
Pacific Dental Services is an Equal Opportunity Employer. We celebrate diversity and are united in our mission to create healthier and happier team members.
The primary function of the Associate Analyst, Revenue Operations is to effectively assist in production and collections. This individual works closely with the Analyst, Collections II and assists on action plans developed for opportunities identified. The Associate Analyst, Revenue Operations ensures that claims are properly billed to the patients and insurance companies and ultimately paid. This position is proactive in its efforts to ensure insurance companies are billed correctly and promptly, as well as receivables are collected effectively in each office.
Responsibilities
Assist Analyst, Revenue Operations to maximize office collections, communicate issues and implement guidelines/parameters to improve processes.Analyze various internal and external reports to review/trace outstanding and complex claim payments, request additional information from practices, make claim corrections, re-submit, and appeal with carriers for proper payment.Assist in identifying strategic financial solutions for Regional Manager (RM) and Operations Manager (OM) to drive higher percentage of payments, faster billing cycles and top line revenue.Analyze the AR Metrics to identify offices that need training or billing process improvements.Identify opportunities and present to Collections Analyst II to work with regions on best practices and more efficient billing processes.Perform daily activities of auditing and billing of assigned practice's patient claims to ensure accurate and maximum reimbursement for patient treatment from insurance carriers.Analyze Explanation of Benefits (EOB) statements and adjust accounts according to PDS claims processing criteria.Identify necessary adjustments to accounts and use negotiation skills to obtain claims approval and payment information from various carriers.Review and examine AR Report to ensure accounts are properly billed to the insurance.Weekly, check the portals (e.g. Request for Information (RI), and Claims Portal) to ensure that any missing information is obtained, so that the claims are billed properly and claims are properly adjudicated.Partner with Analyst II, Collections to provide feedback around maximizing the collectable revenue for the region/office.Communicate trends and suggestions to improve processes to Collections Analyst II.Other duties as assigned by management.Required
Bachelor's Degree in Finance, Business Administration or related field. In lieu of degree, 1+ years of claims auditing or related experience is required.Experience working with QSI (Quality Systems Inc.).Strong computer and data entry skills with competent knowledge of Microsoft Word, Outlook and Excel software applications.Preferred
Previous Operation Management experience in with a retail store or medical/dental practice.Insurance Claims Auditing experience.Benefits
Medical, dental, and vision insurancePaid time offTuition Reimbursement401KPaid time to volunteer in your local community
Pacific Dental Services is an Equal Opportunity Employer. We celebrate diversity and are united in our mission to create healthier and happier team members.