Tellus, part of the Netsmart family, is the leading provider of (EVV)technology and claim processing software and are extremely proud to be the provider of choice for many states, payers and agencies who utilize our comprehensive, cloud-based solutions. In compliance with the Gov't mandated,, we are enabling healthcare providers and caregivers to focus their efforts on what matters most -improved patient care with better outcomes, operational efficiency, and ultimately, cost reduction.

What we're looking for:

Due to rapid growth we're needing to add a Claims Analyst to our Production & Claims Processing Support team. In this role we're seeking someone with great attention to detail, who understands the claims process from start to finish, is meticulous in their reporting, proficient at monitoring, processing, and reviewing claims.

What you will do:
- Collaborate with internal teams and departments to ensure Electronic Visit Verification home health visits and claims are processed correctly
- Evaluate accuracy and completeness of information provided to troubleshoot health claim information to ensure correct claim submission and payment
- Track service authorizations for services when appropriate for third party billing
- Interface with TELLUS clients via email and phone to meet all research and claims submission requirements
- Monitor claims processing, payments and monitor for processing results
- Analyze provider issues and collaborate with other departments to resolve. Identifies and documents opportunities for provider education
- Review provider disputes or appeals and provide a detailed analysis of findings
- Conduct claim testing for TELLUS products
- Offer expertise and assistance relative to provider billing and payment guidelines consistent with Medicaid claims policies
- Document all provider contacts; including phone calls, emails, and written correspondence
- Troubleshoot and identify root cause of problems and participate in developing solutions
- Provide follow up and intervention relating to provider claim inquiries
- Participate in and maintain highest level of training and knowledge on software for billing
- Contributes to team effort by accomplishing related results as needed
- Ensure integrity and confidentiality of all claims and other data

Qualifications:
- Minimum of 3-5 years of relevant experience
- High School Diploma/GED required
- Experience problem solving, troubleshooting and analyzing needs
- Excellent customer service skills
- The ability to communication well VIA email (written) and telephone
- Attention to detail/thorough

Preferred Qualifications:
- healthcare claims experience
- Medical coding certification
- Call center work experience

Netsmart is proud to be an equal opportunity workplace and is an affirmative action employer, providing equal employment and advancement opportunities to all individuals. We celebrate diversity and are committed to creating an inclusive environment for all associates. All employment decisions at Netsmart, including but not limited to recruiting, hiring, promotion and transfer, are based on performance, qualifications, abilities, education and experience. Netsmart does not discriminate in employment opportunities or practices based on race, color, religion, sex (including pregnancy), sexual orientation, gender identity or expression, national origin, age, physical or mental disability, past or present military service, or any other status protected by the laws or regulations in the locations where we operate.
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