Analyst, Claims

What We Treat

A full range of mental health and addiction care including:
Depression, Anxiety, PTSD, Borderline Personality Disorder, Bipolar Disorder, Psychosis, Suicidal and Homicidal Ideations, Drug and Alcohol Addiction.

Our Programs

Full continuum of care including:

• 24/7 crisis care and assessment
• Inpatient mental health treatment
• Inpatient drug and alcohol detox and rehab
• Partial hospitalization programs (PHP)
• Intensive outpatient programs (IOP)
• Virtual assessments and outpatient care

Populations Served

• Adults
• Children and adolescents
• Military and veterans
• First responders and frontline professionals (Help for Heroes program)

Summary

The Claims Analyst is responsible for managing billing and collections across multiple facilities, ensuring compliance with payor requirements, and maintaining accurate accounts receivable. This role also supports staff, oversees financial processes, and collaborates with internal departments to ensure timely and accurate reimbursement activities.

Essential Functions

• Accurately perform billing and collections for multiple facilities and all payors
• Maintain accounts receivable at appropriate levels based on payor and acuity mix
• Respond to inquiries from insurance carriers, patients, and families regarding account balances
• Serve as administrator for payor websites and access credentials
• Ensure accurate posting and tracking of financial activity
• Collaborate with Utilization departments to ensure timely pre-certifications, certifications, and appeals
• Assign and manage staff tasks within billing software
• Review and approve adjustments and refunds
• Participate in A/R month-end close processes
• Attend and prepare for weekly A/R meetings
• Develop, implement, and monitor quality assurance activities
• Ensure compliance with laws, regulations, and internal procedures
• Recommend and update policies and procedures as needed
• Provide technical and professional support to staff
• Assist in hiring, supervising, and evaluating staff

Knowledge, Skills and Abilities

• Strong knowledge of Medicare/Medicaid guidelines and UB04 billing requirements
• Proficiency in computerized medical billing systems
• Ability to manage multiple facilities and payor types simultaneously
• Strong analytical and problem-solving skills
• Effective communication with internal teams and external stakeholders
• Ability to lead, supervise, and support staff
• Detail-oriented with strong organizational skills
• Ability to work in a fast-paced, high-volume environment

Education & Experience

• High school diploma or equivalent required; Associate's degree preferred
• 3-5 years of computerized medical billing experience
• Minimum of 1 year experience in behavioral healthcare
• 3-5 years of supervision/management experience in a healthcare setting
• Working knowledge of Medicare/Medicaid and institutional billing requirements

Qualifications

Education: High school diploma or equivalent required; Associate's degree preferred
Experience:

• Strong knowledge of Medicare/Medicaid guidelines and UB04 billing
• 3-5 years medical billing experience
• Behavioral healthcare experience preferred
• Supervisory experience in healthcare setting

Additional Requirements:

• May be required to work flexible hours and overtime

Physical, Mental, and Special Demands

• Ability to sit/stand for at least two-thirds of the shift; walk up to one-third
• Ability to bend, kneel, stoop, twist, and reach as needed
• Visual ability to read documents, charts, and computer screens
• Ability to push/pull carts up to 100 lbs
• Ability to lift 10 lbs frequently; 20-50 lbs occasionally
• Ability to work around cleaning chemicals and potential medical/electrical hazards
• Ability to perform repetitive tasks in a fast-paced environment

EEOC Statement:

Springstone is committed to providing Equal Employment Opportunities for all applicants and employees and complies with all applicable laws prohibiting discrimination against any employee or applicant for employment because of color, race, sex, age, religion, national origin, disability, genetic information, gender identity, sexual orientation, veterans' status or any other basis protected by applicable federal, state or local law.

Lifepoint Health is a leader in community-based care and driven by a mission of Making Communities Healthier. Our diversified healthcare delivery network spans 29 states and includes 63 community hospital campuses, 32 rehabilitation and behavioral health hospitals, and more than 170 additional sites of care across the healthcare continuum, such as acute rehabilitation units, outpatient centers and post-acute care facilities. We believe that success is achieved through talented people. We want to create places where employees want to work, with opportunities to pursue meaningful and satisfying careers that truly make a difference in communities across the country.