Healthcare Payer Support Analyst (healthcare billing, 837, ICD-10 expertise) - Remote

As a Healthcare Payer Support Analyst at Experian, your core responsibilities will include reviewing internal processes to recommend changes for improved efficiency and effectiveness. You’ll be tasked with documenting solutions for clients, analyzing customer data, and providing vital technical support. Your role also involves maintaining client relationships, monitoring project tasks, and participating in regular client calls to ensure continuous support and satisfaction.

To apply for the Healthcare Payer Support Analyst position at Experian, you will need at least 4 years of hospital and physician billing experience, along with a solid understanding of ICD-10 diagnosis and procedure codes and the healthcare 837 format. Familiarity with ADA paper forms and a keen attention to detail are also critical, as you will be responsible for performing claims conversions and ensuring the accuracy of all assigned jobs.

The work environment for a Healthcare Payer Support Analyst at Experian is flexible and remote, promoting a healthy work-life balance. You'll be part of a collaborative team that values diversity and innovation, allowing you to work from home while contributing to the future of healthcare. Experian's dedication to employee well-being is reflected in our comprehensive benefits package and commitment to creating a welcoming workplace culture.

Experian offers a range of training and development opportunities to Healthcare Payer Support Analysts to ensure continuous professional growth. You'll receive input on improving product documentation and training processes, which allows you to enhance your skills. Moreover, the company promotes a culture of learning with access to various resources that encourage innovation and professional development.

Experian wholeheartedly supports diversity and inclusion in the workplace, recognizing that a diverse workforce drives our innovative approaches. As a Healthcare Payer Support Analyst, you will join a culture that values different perspectives and experiences, ensuring everyone can bring their whole self to work. Our commitment is reflected in numerous awards and our continuous efforts to create an environment where all employees feel valued and engaged.

To ensure accuracy and completeness in my billing processes, I regularly audit my work against payer requirements, utilize healthcare coding software, and continuously stay updated on coding guidelines. I also collaborate closely with team members to cross-check claims and leverage their perspectives to identify potential issues early on.

Certainly! I have over four years of experience using ICD-10 codes, which includes coding for various diagnosis and procedure scenarios. I have been accustomed to regularly reviewing clinical documentation, interpreting physician notes, and accurately assigning the correct codes to ensure compliance and minimize denials.

The healthcare 837 format is an essential electronic file format for submitting healthcare claims. My experience with this format includes preparing claims data, ensuring adherence to the ANSI X12 standards, and troubleshooting any discrepancies that arise during submission. Understanding workflows helps streamline the claims process, which is critical in my role.

When faced with complex billing issues, I first gather all relevant information and analyze the problem systematically. Communication is key, so I collaborate with stakeholders to identify potential solutions and implement changes as needed. I maintain thorough documentation of the issues and resolutions to build a knowledge base for future reference.

In my previous roles, I have worked with several healthcare billing tools such as Epic, Cerner, and other practice management software. My familiarity with these systems allows me to efficiently manage claims, track payments, and generate reports that can aid in decision-making.

In my last position, I noticed recurring errors in our claims submissions. I took the initiative to analyze the root cause and developed a training program that addressed common issues and clarified processes. This resulted in a 20% reduction in claim denials and contributed to faster payments.

When interpreting payer notifications, I first review the contents thoroughly to understand the issue or request. I cross-reference this information with our billing records to identify any discrepancies and then consult with my team to devise a sensible response or corrective action in line with billing protocols.

When managing multiple projects, I assess the urgency and complexity of each task using a project management tool. This enables me to set clear priorities and deadlines. Additionally, I regularly communicate with my team and supervisors to manage expectations and identify areas that may need additional resources.

Data analysis is crucial in billing as it allows me to track payment trends, identify anomalies, and optimize billing processes. By analyzing claims data, I can provide insights that help improve the efficiency and accuracy of our operations, leading to better financial outcomes for our clients.

I have extensive experience performing claims conversions from legacy systems to new platforms, such as Claim Source. The challenges often involve ensuring data integrity during the transition, addressing format discrepancies, and training users on the new system. By establishing clear guidelines and thorough testing, I have successfully mitigated these challenges.