Integra Partners is hiring a
Payment Analyst

Summary

Join Integra Partners as a Payment Analyst and contribute your DME claims industry expertise to drive business outcomes.

Requirements

• Bachelor’s degree desired or equivalent experience
• Ability to work well in a high-growth, fast-moving, entrepreneurial environment
• Desire to come in and implement new processes
• Excellent written and verbal communication skills
• Proven ability to build strong partnerships across the organization, influence others, and work collaboratively within a team-oriented environment
• Possess the willingness and ability to get beyond the obvious causes of outliers - and investigate, identify, and summarize the underlying root causes
• Efficient time and resource management skills to ensure that the service level provided exceeds expectations with a strong commitment to team success and team goals
• Comfort with ambiguity and ability to effectively multi-task, make tradeoffs, take initiative, and prioritize within a fast-paced, demanding environment
• Familiarity with the 1500 claim forms, and DMEPOS services
• Knowledge of ICD-10, HCPCS, and medical terminology
• Understanding of CMS guidelines, and Medical Policy adopted by the plans
• Experience working in health insurance specifically with claims processing, billing, reimbursement, or provider contracting
• Possess investigative skills to independently conduct all claims and payment reviews, as well as other insurance related investigations

Responsibilities

• Assist in investigating any Electronic Remittance Advices (ERA)/835 issues with our clearinghouse, payer clearinghouse or payer directly to ensure seamless delivery of 835s
• Coordinate payer/provider outreach to obtain missing information needed to be able to apply payments or recoupments received
• Assist the payment posting team with identifying, researching, and ensuring timely processing of large payment projects, ensuring payments, denials, and recoupments are appropriately applied
• Investigating the source of unapplied payments to ensure they are applied to the correct claims
• Provide expertise on CMS and state Medicaid guidelines for informing reports & processes on DME unit allowable and frequency guidelines
• Assist with the testing of new payers added to the payment integrity monitoring workstreams
• Help coordinate the initial outreach and follow-ups for actionable insights from payment integrity monitoring
• Review samples of denial trends to assist with identifying whether a denial is Payer or Provider driven
• Provide interpretation of claim supporting documentation to validate denials received
• Measure provider driven billing trend changes and develop ability to track progress
• Assist with the managing of payment posting inventory across several workstreams

Benefits

• Competitive compensation
• Annual bonus program
• 401(k) retirement program with company match
• Company-paid life insurance
• Company-paid short term disability coverage (location restrictions may apply)
• Medical, Vision, and Dental benefits
• Paid Time Off (PTO)
• Paid Parental Leave
• Sick Time
• Paid company holidays and floating holidays
• Quarterly company-sponsored events
• Health and wellness programs
• Career development opportunities