Claims Analyst- Remote
LifePoint Health, Louisville, KY, United States
Claims Analyst
A full range of mental health and addiction care including: Depression, Anxiety, PTSD, Borderline Personality Disorder, Bipolar Disorder, Psychosis, Suicidal and Homicidal Ideations, Drug and Alcohol Addiction.
Full continuum of care including:
24/7 crisis care and assessment
Inpatient mental health treatment
Inpatient drug and alcohol detox and rehab
Partial hospitalization programs (PHP)
Intensive outpatient programs (IOP)
Virtual assessments and outpatient care
Populations served:
Adults
Children and adolescents
Military and veterans
First responders and frontline professionals (Help for Heroes program)
The Claims Analyst is responsible for managing billing and collections across multiple facilities, ensuring compliance with payor requirements, and maintaining accurate accounts receivable. This role also supports staff, oversees financial processes, and collaborates with internal departments to ensure timely and accurate reimbursement activities.
Essential functions:
Accurately perform billing and collections for multiple facilities and all payors
Maintain accounts receivable at appropriate levels based on payor and acuity mix
Respond to inquiries from insurance carriers, patients, and families regarding account balances
Serve as administrator for payor websites and access credentials
Ensure accurate posting and tracking of financial activity
Collaborate with Utilization departments to ensure timely pre-certifications, certifications, and appeals
Assign and manage staff tasks within billing software
Review and approve adjustments and refunds
Participate in A/R month-end close processes
Attend and prepare for weekly A/R meetings
Develop, implement, and monitor quality assurance activities
Ensure compliance with laws, regulations, and internal procedures
Recommend and update policies and procedures as needed
Provide technical and professional support to staff
Assist in hiring, supervising, and evaluating staff
Knowledge, skills and abilities:
Strong knowledge of Medicare/Medicaid guidelines and UB04 billing requirements
Proficiency in computerized medical billing systems
Ability to manage multiple facilities and payor types simultaneously
Strong analytical and problem-solving skills
Effective communication with internal teams and external stakeholders
Ability to lead, supervise, and support staff
Detail-oriented with strong organizational skills
Ability to work in a fast-paced, high-volume environment
Education & experience:
High school diploma or equivalent required; Associate's degree preferred
35 years of computerized medical billing experience
Minimum of 1 year experience in behavioral healthcare
35 years of supervision/management experience in a healthcare setting
Working knowledge of Medicare/Medicaid and institutional billing requirements
Qualifications:
Education: High school diploma or equivalent required; Associate's degree preferred
Strong knowledge of Medicare/Medicaid guidelines and UB04 billing
35 years medical billing experience
Behavioral healthcare experience preferred
Supervisory experience in healthcare setting
Additional requirements:
May be required to work flexible hours and overtime
Physical, mental, and special demands:
Ability to sit/stand for at least two-thirds of the shift; walk up to one-third
Ability to bend, kneel, stoop, twist, and reach as needed
Visual ability to read documents, charts, and computer screens
Ability to push/pull carts up to 100 lbs
Ability to lift 10 lbs frequently; 2050 lbs occasionally
Ability to work around cleaning chemicals and potential medical/electrical hazards
Ability to perform repetitive tasks in a fast-paced environment
EEOC Statement:
Springstone is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.
A full range of mental health and addiction care including: Depression, Anxiety, PTSD, Borderline Personality Disorder, Bipolar Disorder, Psychosis, Suicidal and Homicidal Ideations, Drug and Alcohol Addiction.
Full continuum of care including:
24/7 crisis care and assessment
Inpatient mental health treatment
Inpatient drug and alcohol detox and rehab
Partial hospitalization programs (PHP)
Intensive outpatient programs (IOP)
Virtual assessments and outpatient care
Populations served:
Adults
Children and adolescents
Military and veterans
First responders and frontline professionals (Help for Heroes program)
The Claims Analyst is responsible for managing billing and collections across multiple facilities, ensuring compliance with payor requirements, and maintaining accurate accounts receivable. This role also supports staff, oversees financial processes, and collaborates with internal departments to ensure timely and accurate reimbursement activities.
Essential functions:
Accurately perform billing and collections for multiple facilities and all payors
Maintain accounts receivable at appropriate levels based on payor and acuity mix
Respond to inquiries from insurance carriers, patients, and families regarding account balances
Serve as administrator for payor websites and access credentials
Ensure accurate posting and tracking of financial activity
Collaborate with Utilization departments to ensure timely pre-certifications, certifications, and appeals
Assign and manage staff tasks within billing software
Review and approve adjustments and refunds
Participate in A/R month-end close processes
Attend and prepare for weekly A/R meetings
Develop, implement, and monitor quality assurance activities
Ensure compliance with laws, regulations, and internal procedures
Recommend and update policies and procedures as needed
Provide technical and professional support to staff
Assist in hiring, supervising, and evaluating staff
Knowledge, skills and abilities:
Strong knowledge of Medicare/Medicaid guidelines and UB04 billing requirements
Proficiency in computerized medical billing systems
Ability to manage multiple facilities and payor types simultaneously
Strong analytical and problem-solving skills
Effective communication with internal teams and external stakeholders
Ability to lead, supervise, and support staff
Detail-oriented with strong organizational skills
Ability to work in a fast-paced, high-volume environment
Education & experience:
High school diploma or equivalent required; Associate's degree preferred
35 years of computerized medical billing experience
Minimum of 1 year experience in behavioral healthcare
35 years of supervision/management experience in a healthcare setting
Working knowledge of Medicare/Medicaid and institutional billing requirements
Qualifications:
Education: High school diploma or equivalent required; Associate's degree preferred
Strong knowledge of Medicare/Medicaid guidelines and UB04 billing
35 years medical billing experience
Behavioral healthcare experience preferred
Supervisory experience in healthcare setting
Additional requirements:
May be required to work flexible hours and overtime
Physical, mental, and special demands:
Ability to sit/stand for at least two-thirds of the shift; walk up to one-third
Ability to bend, kneel, stoop, twist, and reach as needed
Visual ability to read documents, charts, and computer screens
Ability to push/pull carts up to 100 lbs
Ability to lift 10 lbs frequently; 2050 lbs occasionally
Ability to work around cleaning chemicals and potential medical/electrical hazards
Ability to perform repetitive tasks in a fast-paced environment
EEOC Statement:
Springstone is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.