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 performs billing and collections for multiple facilities for all payors.
• Provides professional and technical support to staff.
• Responds to requests from insurance carriers, family members and patients regarding account balance issues.
• Act as administrator for payor website/log in access.
• Ensures accurate capturing and posting of financial activity and maintains accounts receivable at amounts appropriate for payor and acuity mix for all facilities
• Actively works with the Utilization departments in all facilities to ensure pre-certifications, certifications, and appeals are completed accurately and in a timely manner.
• Complete Effective follow up on claims
• Review and understand Payor Contracts and Reimbursement
• Review and understand Payor EOBs/Remits/EOPs
• Research and resolve claim issues
• Review denials  - Write and submit appeals
• Attends and prepares for weekly AR Calls.
• Assists with A/R Month End close process.
• Accurately perform billing and collections for multiple facilities for all payors

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 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

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 and stand (at least two-thirds of the shift) and walk (possibly one-third of the shift).
• Ability to reach above, or below waist height, kneel, bend, stoop, turn, and twist (occasionally to frequently).
• Visual ability to read charts, treatment plans, financial documents, computer screen and typewritten materials.
• Ability to frequently push/pull wheeled carts to 100 pounds.
• Ability to frequently lift and carry 10 lbs.; occasionally 20 to 50 lbs.
• Ability to work in an environment where chemicals are frequently used for cleaning, where medical and electrical hazards may be present and where dust, mist and steam are frequently generated in housekeeping tasks.
• Ability to work at a rapid pace and perform a variety of repetitive duties.

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.