Provider Application Analyst

Posted:
11/25/2024, 7:11:56 AM

Location(s):
Rapid City, South Dakota, United States ⋅ South Dakota, United States

Experience Level(s):
Junior ⋅ Mid Level

Field(s):
Customer Success & Support

Current Employees:

If you are a current employee, please apply via the internal career site by logging into your Workday Account and clicking the "Career" icon on your homepage.

Primary Location

Rapid City, SD USA

Department

CS Managed Care

Scheduled Weekly Hours

0

Starting Pay Rate Range

$16.40 - $20.50

(Determined by the knowledge, skills, and experience of the applicant.)

Job Summary

Ensures the proper interpretation, processing, recording, approval and payment of client billing services. Accurately reviews information for processing charges and payments into a computerized system in accordance with the billing and collection guidelines. Responsible for the review and analysis of outstanding account balances for all Client services. Telephones/contacts debtors to accelerate payment of outstanding accounts. Conducts a variety of tasks related to accelerate payment of outstanding Client balances. Attempts to anticipate any and all problems relating to payment of client accounts and attempts to solve these problems.

Monument Health offers competitive wages and benefits on qualifying positions. Some of those benefits can include:

*Supportive work culture

*Medical, Vision and Dental Coverage

*Retirement Plans, Health Savings Account, and Flexible Spending Account

*Instant pay is available for qualifying positions

*Paid Time Off Accrual Bank

*Opportunities for growth and advancement

*Tuition assistance/reimbursement

*Excellent pay differentials on qualifying positions (extra pay for working evening, nights or weekends)

*Flexible scheduling

Job Description

Essential Functions:

  • Conducts timely follow up of client accounts as needed.
  • Demonstrates the ability to recognize problem situations in the reimbursement process and initiate an appropriate response as evidenced by documentation and feedback.
  • Maintains individual production and audit reports.
  • Processes charges/claims in a timely manner according to internal departmental standards and meets any production standards that are in place.
  • Responsible for accurate, timely billing of client billing in accordance with established guidelines and compliance regulations.
  • Responsible for personal organization of activities and adherence to personnel policies and procedures.
  • Assists in processing new and reappointment applications including but not limited to board certifications, all state licenses, databanks, federations, credentials verification, exclusion checks, etc.
  • Reviews, analyzes, and assures the completion of information required for initial appointment and recredentialing/reappointment. Follows legal, state and federal agencies, state licensing board, the Joint Commission (TJC), NCQA, and Risk Management guidelines and/or regulations to assure that the application is complete and ready for review by Board of Directors.
  • Responsible for accurate, timely filing of claims in accordance with established guidelines and compliance regulations.
  • Responsible to ensure quality services in claim submission is given in accordance to applicable policies, procedures and guidelines.
  • All other duties as assigned.

Additional Requirements

Required:
Education - High School Diploma/GED Equivalent in General Studies

Preferred:
Experience - 5+ years of Billing/Collections Experience

Physical Requirements:
Sedentary work - Exerting up to 10 pounds of force occasionally and/or negligible amount of force frequently or constantly to lift, carry, push, pull or otherwise move objects, including the human body. Sedentary work involves sitting most of the time.

Job Category

Revenue Cycle

Job Family

Patient Financial Services

Shift

Employee Type

PRN


15 Corporate Services Division

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Monument Health is an Equal Opportunity/Affirmative Action employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, or protected Veteran status.