Job Description

The Self Pay Integrity Analyst - REMOTE is responsible for performing review of patient balances, ensuring adjustments/discounts are applied appropriately, and ensuring timely review of patient account balances. This role requires extensive knowledge of EOB and remittance advice's, documentation of account activity, and adherence to applicable regulations to support revenue cycle operations. 

Essential Functions

Review follow-up on patient balances within the required timeframe. Documents all actions taken on accounts within the appropriate system, ensuring a clear and traceable resolution process. Handles and resolves self-pay  within the required timeframe and  updates the system with relevant information. Analyzes assigned accounts using AS400, Meditech, Accurint, Cerner, directory assistance, and credit reports to maximize collection efforts. Ensures proper application of account dispositions and follows self-pay policies and procedures. Adheres to all local, state, and federal laws and regulations, including FDCPA, TCPA, FCRA, CFPB, PCI, UDAAP, and HIPAA compliance standards. Performs other duties as assigned. Complies with all policies and standards.

Qualifications

H.S. Diploma or GED required Associate Degree in Business, Finance, Healthcare Administration, or a related field preferred 0-2 years of experience in medical collections, accounts receivable, billing, or healthcare revenue cycle operations required Experience working with insurance follow-up, claim resolution, and payer communication in a healthcare setting preferred

Knowledge, Skills and Abilities

Strong understanding of medical collections processes, payer reimbursement policies, and insurance claim resolution. Proficiency in electronic medical record (EMR) systems, patient accounting systems, and collections software. Knowledge of insurance contracts, denials management, and accounts receivable workflows. Excellent problem-solving and analytical skills to research and resolve outstanding claims. Effective verbal and written communication skills to interact with insurance payers, patients, and internal teams. Strong attention to detail with the ability to document account activity accurately. Ability to work independently in a fast-paced environment while meeting productivity and quality standards. Knowledge of regulatory compliance, including HIPAA, FDCPA, and applicable healthcare finance laws.