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Position Purpose The Senior Insurance and Claims Specialist is responsible for compliant billing ... Operations Analysts and Information Technology to maintain and improve business system changes ...
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Reno, NV · On-site
$22.16 - $31.03/hr
Position Purpose The Senior Insurance and Claims Specialist is responsible for compliant billing ... Operations Analysts and Information Technology to maintain and improve business system changes ...
Position Purpose The Senior Insurance and Claims Specialist is responsible for compliant billing ... Operations Analysts and Information Technology to maintain and improve business system changes ...
Position Purpose The Senior Insurance and Claims Specialist is responsible for compliant billing ... Operations Analysts and Information Technology to maintain and improve business system changes ...
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Senior Insurance Data Analytics information
What are the key skills and qualifications needed to thrive as a Senior Insurance Data Analytics professional, and why are they important?
What does a Senior Insurance Data Analytics professional do?
What is the difference between Senior Insurance Data Analytics vs Insurance Data Analyst?
| Aspect | Senior Insurance Data Analytics | Insurance Data Analyst |
|---|---|---|
| Required Credentials | Bachelor's or Master's in Data Science, Statistics, or related field; often with experience in insurance analytics | Bachelor's in related field; entry to mid-level experience |
| Work Environment | Senior roles often involve leadership, project management, and strategic planning within insurance companies | Focus on data collection, analysis, and reporting under supervision or team guidance |
| Employer & Industry Usage | Used across insurance firms, especially in analytics, underwriting, and actuarial departments | Commonly employed in insurance companies, focusing on data processing and reporting |
Senior Insurance Data Analytics professionals typically have more experience, advanced skills, and leadership responsibilities compared to Insurance Data Analysts. While both roles require strong analytical skills and familiarity with insurance data, seniors often oversee projects, develop strategies, and mentor junior staff, whereas analysts focus on data analysis and reporting tasks.
What are some common challenges faced by Senior Insurance Data Analytics professionals when working with large and complex datasets?
Renown Health rating
7.5
Based on 97 frontline employees who took The Breakroom Quiz
231st of 886 rated healthcare providers
Job description
Position Purpose
The Senior Insurance and Claims Specialist is responsible for compliant billing, account follow up and system operations to ensure timely and accurate claim submission and prevention of denials per regulatory and payor requirements, as well as improved payment turnaround.
Nature and Scope
The Senior Insurance and Claim Specialist is responsible for:
• Optimization of system that will ensure accurate claim submission and follow-up resulting in timely reimbursement per payor and regulatory guidelines.
• Complete detailed appeal of denial or payment variance to payor, incorporating contract terms, clinical or regulatory justification for reconsideration or additional reimbursement.
• Recommend system changes for clean claim submission to aid in the prevention of denials.
• Work with the Renown Contracting Department or payor representatives to resolve billing issues due to payor or regulatory changes affecting the billing of healthcare claims.
• Assisting with testing and troubleshooting of system for payor or regulatory changes.
• Maintaining expertise for all payor, HIPAA and other regulatory changes affecting the billing of healthcare claims.
• Working hand in hand with Operations Analysts and Information Technology to maintain and improve business system changes based on payor or regulatory changes.
• Acts as a resource for staff on all areas relating to edit and denial/rejection resolution.
• Identify trends in payor non-compliance and inform management if not able to resolve with payor.
• Demonstrates a thorough knowledge of all department functions, processes, and procedures.
This position does not provide patient care
Disclaimer
The foregoing description is not intended to be, and should not be construed as, an exhaustive list of all responsibilities, skills, efforts, or working conditions associated with the job. It is intended to be an accurate reflection of the general nature and level of the job.
Minimum Qualifications
Requirements - Required and/or Preferred
Name
Description
Education:
Ability to read, write, speak, and understand English sufficiently to perform job duties safely and effectively. Associates Degree Preferred.
Experience:
Two years healthcare billing office experience with extensive knowledge of healthcare billing, government and third party payor requirements.
License(s):
None
Certification(s):
Coding Certification Preferred for Professional Billing.
Computer / Typing:
Must be proficient with Microsoft Office Suite, including Outlook, PowerPoint, Excel, Teams, and Word and have the ability to use the computer to complete online learning requirements for job-specific competencies, access online forms and policies, complete online benefits enrollment, etc.
What Renown Health employees say
Pay
Benefits
Hours and flexibility
Workplace
Get the full story on Breakroom
About Renown Health
Sourced by ZipRecruiter
Renown Health is a leading and respected player in the healthcare industry, based in Reno, NV, US. Established in 1862, the company has a deep-rooted history in providing high-quality healthcare services to the community. Renown Health offers a wide array of services including urgent care centers, lab services, x-ray and imaging services, primary care doctors and specialists. Its central values include excellence in quality and service, caring for people first, being proactive in the community, fiscal responsibility, integrity, and respecting every person.
Industry
Health care and social assistance
Company size
5,001 - 10,000 Employees
Headquarters location
Reno, NV, US
Year founded
1862