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Northeast Georgia Health System
Gainesville, Georgia
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PIH Health
Los Angeles, California
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Payment Resolution Analyst
Job Summary: The Payment Resolution Analyst processes all out of network insurance claims to ensure appropriate payments are received, negotiates payments with payers, provides good faith estimates to potential patients and processes and follows up on independent dispute resolution appeals. Responsibilities: Reconciles billing and payment data on an automated system to maintain and update receivable status on out of network payments posted on the patients' account. Communicates with third party payers by means of correspondence or by telephone to start payment negotiation on accounts that are deemed "underpaid" per set guidelines. Reviews payments to assess if account will be sent
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