Enhanced Claim Resolution Operations, Senior Analyst



IT, Operations
Belfast, ME, USA
Posted on Saturday, November 4, 2023

Join us as we work to create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

Position Summary: The Enhanced Claim Resolution Operations Analyst is responsible for analyzing a queue of work related to revenue cycle success. This includes working claims for payers that cannot be contacted by our business partners and/or other health insurance claim-based work excluded from our standard workflows. Following established workflows and identified best practices, you will research, and resolve claims to support the creation of a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all. Your responsibilities will include analysis and appropriate resolution of a queue of work within a contractually specified timeframe in the most efficient manner possible, identifying trends through observation and investigation, and escalating opportunities for improvement to the appropriate business unit.

Essential Functions (Duties and Responsibilities):

80% Queue Based Work

  • Ensures accurate entry of information into athenaNet and trading partner applications.

  • Builds and maintains expert subject matter knowledge of assigned processes in order to be a resource for clients and internal stakeholders

  • Works with key stakeholders (internal and/or external) across geographies to perform tasks

  • Removes obstacles and works independently to ensure completion of assigned tasks within specified turnaround times and adhering to established goals

  • Prioritizes work effectively in a fast-paced environment

  • Demonstrates flexibility & adaptability when business directives change

  • Possesses a high level of attention to detail and holds self to equally high-quality standards

  • Embodies athenahealth’s values and behaviors

  • Leverages all available resources to solve problems

10% Trend Identification/Critical Thinking & Problem Solving

  • Identifies and surfaces workflow inconsistencies

  • Communicates opportunities for innovation and process refinement

  • Evaluates alternative methodologies when applicable and implements appropriate solutions to new problems

  • Presents information and concepts in a professional and organized manner

  • Leverages all available resources to solve problems

  • Identify error trends in your work and escalate where appropriate

  • Navigate the organization with professionalism

10% Training & Professional Development

  • Participates in training opportunities by leveraging appropriate growth

  • Shares useful information with teams when appropriate

  • Accepts, delivers and implements both positive and constructive feedback

  • Demonstrates behaviors of our Values

  • Engages in dialogue to facilitate trust and understanding of others

  • Initiates opportunities to experience and learn new skills in support of personal career development

  • Provides training & mentoring to peers to ensure client needs are met and work is completed accurately

  • Becomes an engaged and active participant in athenahealth’s teaching and learning culture by demonstrating tenacity and teamwork

  • Demonstrates commitment to becoming a subject matter expert

Education & Experience Required:

  • Bachelor’s degree preferred or 2-4 years of professional experience preferred

  • Effective communication and business writing skills

  • Microsoft Office Suite, basic computer skills including proficient typing and navigation

Knowledge & Skills:

  • Effective communication and interpersonal relationship skills

  • Solid planning and organizational abilities

  • Time management skills and ability to prioritize work based on criticality

  • Critical thinking and problem-solving skills

  • Works independently as well as part of an extended, cross-functional team

  • Experience working with cross-functional groups and teams to achieve common goals

  • Flexibility and adaptability in approach to challenges to achieve desired outcomes

  • Displays initiative, tenacity and flexibility in a fast-paced team environment

  • Attention to detail

About athenahealth

Here’s our vision: To create a thriving ecosystem that delivers accessible, high-quality, and sustainable healthcare for all.

What’s unique about our locations?
From an historic, 19th century arsenal to a converted, landmark power plant, all of athenahealth’s offices were carefully chosen to represent our innovative spirit and promote the most positive and productive work environment for our teams. Our 10 offices across the United States and India — plus numerous remote employees — all work to modernize the healthcare experience, together.

Our company culture might be our best feature.
We don't take ourselves too seriously. But our work? That’s another story. athenahealth develops and implements products and services that support US healthcare: It’s our chance to create healthier futures for ourselves, for our family and friends, for everyone.

Our vibrant and talented employees — or athenistas, as we call ourselves — spark the innovation and passion needed to accomplish our goal. We continue to expand our workforce with amazing people who bring diverse backgrounds, experiences, and perspectives at every level, and foster an environment where every athenista feels comfortable bringing their best selves to work.

Our size makes a difference, too: We are small enough that your individual contributions will stand out — but large enough to grow your career with our resources and established business stability.

Giving back is integral to our culture. Our athenaGives platform strives to support food security, expand access to high-quality healthcare for all, and support STEM education to develop providers and technologists who will provide access to high-quality healthcare for all in the future. As part of the evolution of athenahealth’s Corporate Social Responsibility (CSR) program, we’ve selected nonprofit partners that align with our purpose and let us foster long-term partnerships for charitable giving, employee volunteerism, insight sharing, collaboration, and cross-team engagement.

What can we do for you?
Along with health and financial benefits, athenistas enjoy perks specific to each location, including commuter support, employee assistance programs, tuition assistance, employee resource groups, and collaborative workspaces — some offices even welcome dogs.

In addition to our traditional benefits and perks, we sponsor events throughout the year, including book clubs, external speakers, and hackathons. And we provide athenistas with a company culture based on learning, the support of an engaged team, and an inclusive environment where all employees are valued.

We also encourage a better work-life balance for athenistas with our flexibility. While we know in-office collaboration is critical to our vision, we recognize that not all work needs to be done within an office environment, full-time. With consistent communication and digital collaboration tools, athenahealth enables employees to find a balance that feels fulfilling and productive for each individual situation.