Claims Analyst

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Closing Date :

10 / 24 / 2024Type of Position : Professional Staff - Project / Program AdministrationJob Type : Regular Work Shift :

Sponsorship Available :

NoInstitution Name : University of Arkansas for Medical Sciences

The University of Arkansas for Medical Sciences (UAMS) has a unique combination of education, research, and clinical programs that encourages and supports teamwork and diversity.

We champion being a collaborative health care organization, focused on improving patient care and the lives of Arkansans.

UAMS offers amazing benefits and perks (available for benefits eligible positions only) :

• Health : Medical, Dental and Vision plans available for qualifying staff and family
• Holiday, Vacation and Sick Leave
• Education discount for staff and dependents (undergraduate only)
• Retirement : Up to 10% matched contribution from UAMS
• Basic Life Insurance up to $50,000
• Career Training and Educational Opportunities
• Merchant Discounts
• Concierge prescription delivery on the main campus when using UAMS pharmacy

Below you will find the details for the position including any supplementary documentation and questions you should review before applying for the opening.

To apply for the position, please click the Apply link / button.

The University of Arkansas is an equal opportunity, affirmative action institution. The University does not discriminate in its education programs or activities (including in admission and employment) on the basis of age, race, color, national origin, disability, religion, marital or parental status, protected veteran status, military service, genetic information, or sex (including pregnancy, sexual orientation, and gender identity).

Federal law prohibits the University from discriminating on these bases. Questions or concerns about the application of Title IX, which prohibits discrimination on the basis of sex, may be sent to the University's Title IX Coordinator and to the U.

S. Department of Education Office for Civil Rights.

Persons must have proof of legal authority to work in the United States on the first day of employment.

All application information is subject to public disclosure under the Arkansas Freedom of Information Act.

At UAMS we value Diversity, Equity and Inclusion.

For general application assistance or if you have questions about a job posting, please contact Human Resources at [email protected].

Department : FIN CORE CCBO Non-Contract

Department's Website :

Summary of Job Duties : As a Claims Analyst, you will be responsible for analyzing and processing insurance claims to ensure accurate reimbursement for healthcare services provided by a medical facility or healthcare provider.

Your role involves reviewing claim submissions, verifying insurance coverage, investigating discrepancies, and facilitating timely claims resolution.Qualifications :

Minimum Qualifications :

• Baccalaureate Degree; Major in Business Administration, Accounting, Finance, Healthcare or related + 3 years' experience or HS + 7 years' experience.
• Experience in healthcare revenue cycle operations involving billing, follow-up or collections including 6 months hospital billing experience.
• Must be familiar with Windows environment and billing software.
• Ability to accurately read, analyze and interpret contract documents for all payers to determine reimbursement.
• Ability to analyze credit balance to advise refund department who should receive the refund.

Additional Information :

Additional Information :

• Reviews and corrects all claims that fail the billing system edits daily to ensure accurate and timely submission on accounts.
• Updates billing system and web-based application with contract global insurance and other billing information. Applications used may include EPIC, One Content, AHIN, Arkansas Medicaid portal, other web-based insurance applications and all Microsoft Office products.
• Monitors existing Global and Transplant guarantor accounts for accurate registration, correcting and reporting errors as they are found.
• Reports all new claim-billing issues to Manager immediately in order to coordinate with other departments and the electronic billing vendors to resolve barriers, when necessary.
• Answers questions and provides appropriate information to fellow team members regarding the billing process and requirements for the global process.
• Follows up on various EPIC work queues including Claim Edits and Follow-up.
• Collects claims for package billing and monitors electronic billing for several carriers.
• Bundles paper claims, including physician claims, for submission to payors. .
• Maintains accurate files and spreadsheets for global resolution.
• Prepares spreadsheets for payment posting.
• Position requires strong understanding of the entire revenue cycle from registration through claim resolution.
• Determines financial responsibilities for billing and resolves problems.
• Provides timely and consistent follow-up for global and non-global transplant guarantors, reporting errors in a timely manner once found.
• Stays abreast of the latest developments, advancements and trends in the field of medical billing by attending in-services, reviewing online information, reading information from payers and fiscal intermediary.
• Comply with safety principles, laws, regulations and standards associated with, but not limited to CMS, Joint Commission, EMTALA and OSHA.
• Contributes to reports of findings and recommendations, timeframes for changes or updates, and recommends operations changes and procedure updates for departments and training.

Feedback is used to improve performance.

• Monitors and resolves credit balances on Global source accounts.
• Conducts research to analyze and resolve insurance-related, coding-related and billing-related denials and exceptions on non-global Transplant guarantor accounts.
• Contacts carriers, uses EOB's to research payments and denials as well as electronic medical records (EMR's) to review coding, audit accounts and internal files and records, and review billing procedures and technical guides to determine errors and opportunities for correction.
• Communicates with providers of service and clinical department personnel to resolve charge denials or rejections.
• Attends department and campus meetings to present information on problems, changes, updates or issues of procedures based upon trends or problems identified and upon the unique procedures associated with various contracts.
• Maintains a good working relationship with patients and families, visitors, physicians and other employees; follows hospital guest relations guidelines and "Circle of Excellence" criteria;
• offers frequently to assist other employees when needed making a conscious effort to recognize and support co-workers; demonstrates a professional appearance and demeanor and adheres to the hospital and department dress code;

demonstrates effective communication skills with all staff and other third party payers; adheres to and enforces code of conduct, campus, hospital and department policies and procedures.

Salary Information :

Commensurate with education and experience

Required Documents to Apply :

List of three Professional References (name, email, business title), Resume

Optional Documents :

Special Instructions to Applicants :

Recruitment Contact Information :

Please contact [email protected] any recruiting relatedquestions.

All application materials must be uploaded to the University of Arkansas System Career

Please do not send to listed recruitment contact.

Pre-employment Screening Requirements : Criminal Background Check

This position is subject to pre-employment screening (criminal background, drug testing, and / or education verification).

A criminal conviction or arrest pending adjudication alone shall not disqualify an applicant except as provided by law. Any criminal history will be evaluated in relationship to job responsibilities and business necessity.

The information obtained in these reports will be used in a confidential, non-discriminatory manner consistent with state and federal law.

Constant Physical Activity : Hearing, Manipulate items with fingers, including keyboarding, Sitting, TalkingFrequent Physical Activity : Kneeling, Reaching, StandingOccasional Physical Activity : Crouching, Kneeling, Lifting, WalkingBenefits Eligible : Yes