Revenue Integrity Administrative Analyst

Los Angeles, California

Employer: UCLA Health
Industry: Ambulatory/Clinical Care Services
Salary: $30.56 - $60.82 per hour
Job type: Full-Time
Description

As a Revenue Integrity Administrative Analyst, you will play a crucial role in managing and auditing claims to ensure accuracy and compliance. Key responsibilities include:
  • Track and follow up on Stop-loss related claims for various carriers, including sending re-bills and addressing denied claims.
  • Audit claims leakage for all Managed Care payors, validate capitation deductions, ensure contractual rates are applied, and provide executive summaries for Stop-loss, TPL, and other recovery items.
  • Initiate, track, and follow up on TPL claims, interface with vendors, law firms, providers, and patients, and collaborate with programmers to enhance claims recovery processes.
  • Implement processes to identify under-allowed claims, review EOBs for accurate payment postings, verify contracts, analyze variances, and validate underpayments in accordance with payer policies.
  • Establish effective contacts with payer offices, inform management of payer performance issues, compile appeals for reimbursement, prepare monthly performance statistics, and participate in meetings to discuss managed care contract trends.
  • Maintain confidentiality of medical records and stay current with managed care reimbursement trends.

Salary Range: $30.56-$60.82/hourly
Created: 2024-09-13
Reference: 20826410
Country: United States
State: California
City: Los Angeles
ZIP: 90291

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