Health Insurance Analyst
Monitors and maintains expertise on all guidance and requirements of agencies that regulate medical, insurance licenses and certificates including providing information/updates and technical assistance services as appropriate.
- Establishes and maintains strong relationship with organizations/agencies that regulate policies and guidelines.
- Responsible for sharing related billing, credentialing and FTCA policy changes or updates to staff and health center staff.
- Developed and maintain a reimbursement procedure manual for FQHC's to utilize to orient new staff.
- Provide on-site technical assistance training to community health center members of the association on billing and CPT correct coding guidelines.
- Insure consistency of distributed messages and materials concerning private and public health insurance agencies.
- Maintaining knowledge of commercial and governmental policy and procedural changes, ensuring the community health center staff is compliant with the changes.
- Credentialing and enrollment services to contracted Federally Qualified Health Centers.
- Primary sources verification of new and existing providers in a timely manner.
- Establish relationship with health plans in addressing credentialing needs to help resolve billing and authorization issues.
- Supervise staff of 3, training and monitoring the credentialing process. Reporting to the health centers the status of providers in the credentialing process. Monitor productivity and escalation issues. Conducting annual performance review.