Cpsi
From Cpsi's careers page
Status: listed on the employer's own careers page when we last checked (daily). Confirm on their site before applying.
This role involves analyzing A/R data, performing claim status checks, handling denials, and maintaining compliance with U.S.
The AR Analyst is responsible for the timely follow-up and resolution of insurance claims to ensure accurate and efficient reimbursement for healthcare providers. This role involves analyzing A/R data, performing claim status checks, handling denials, and maintaining compliance with U.S. healthcare billing and regulatory requirements. The A/R Analyst plays a critical role in optimizing cash flow, reducing days in A/R, and supporting overall revenue cycle performance.
Essential Functions: In addition to working as prescribed in our Performance Factors specific responsibilities of this role include:
Perform pre-call analysis and check claim status via payer calls, IVR, or payer web portals.
Document all claim activities in client software, ensuring a clear and compliant audit trail.
Conduct post-call analysis and record after-call actions for claims follow-up.
Review and interpret Explanation of Benefits (EOBs), authorizations, medical documentation, and physician notes prior to contacting payers.
Analyze A/R data to identify underpayments, denials, and root causes; document with appropriate denial/adjustment codes.
Ensure compliance with all reimbursement, billing, and regulatory requirements (including HIPAA).
Convert denials into payments by filing appeals or correcting claim errors.
Perform eligibility checks, claim submission, and resubmission as required.
Monitor fresh claims, denials, suspensions, and appeals to ensure timely resolution.
Meet or exceed daily/weekly productivity and quality targets.
All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA, and other applicable regulations.
Category
Target
Weightage
Remarks
Production
≥ 100%
40%
Regular claims and denials
Quality
≥ 98.5%
40%
Achieve your set target on a monthly basis
Follow SOPs and Checklists
≥ 95%
10%
Follow SOPs, Site Books, and Checklists
Time on System
9 hrs daily
4%
Meet required 9 hrs time-on-system mandate (only 3 days non-adherence allowed)
Shift Adherence
Login before shift time
3%
Meet required shift start/end mandate (only 2 days non-adherence allowed)
Unapproved Leaves
0
3%
No unapproved leaves allowed
All activities must be in compliance with Equal Employment Opportunity laws, HIPAA, ERISA and other regulations, as appropriate.
High School (HSC) or Graduate equivalent.
2+ years of experience in U.S. healthcare accounts receivable follow-up and/or denial management.
Strong written and verbal communication skills.
Working knowledge of medical terminology, ICD-10, CPT, and HCPCS codes.
Willingness to work continuous night shifts.
Prior experience in U.S. healthcare BPO/RCM preferred.
Experience with acute EHR systems (hospital-based electronic health record platforms).
Familiarity with clearinghouses such as Waystar, Realmed, Availity, Change Healthcare, and ViaTrack.
Proficiency in MS Excel, MS Word, and Google Sheets preferred.
Strong analytical and problem-solving skills with attention to detail.
Assertive and effective in resolving unpaid claims.
Ability to manage multiple tasks while processing high volumes of claims accurately.
Strong organizational and time management skills.
Ability to work independently with minimal supervision.
Commitment to maintaining confidentiality and compliance with HIPAA.
Working Environment/Physical Demands
General office environment: Works generally at a desk in a well-lighted, air-conditioned office, with moderate noise levels.
Periods of stress may occur.
Activities require a significant amount of sitting at office and work desks and in front of a computer monitor.
Some walking and standing relative to interaction with other personnel.
None Occasional Moderate Frequent Very Frequent
(25% or Less) (25% - 40%) (40% - 80%) (80% or m
Other possible Unofficial Titles
Unofficial titles may be given by the manager and used for email signature.
Note: Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time. This document does not create an employment contract, implied or otherwise. It does not alter the "at will" employment relationship between the company and the employe
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