Billing Analyst

Location: Lewisville, TX
Schedule: Monday - Friday, 8:00 AM - 4:30 PM CST

• Remote Days: Monday, Tuesday, Friday

• On-Site Days: Wednesday, Thursday

Job Summary:

We are seeking a highly skilled Billing Analyst to oversee the review and resolution of clearinghouse rejections and payer denials. The ideal candidate will have extensive experience working with commercial and government payers, clearinghouse software, and payer portals. This role requires strong analytical skills, attention to detail, and the ability to collaborate across departments to drive resolution and process improvements.

Key Responsibilities:

• Correct and resend claims through the clearinghouse to resolve eligibility-related rejections (e.g., missing insurance, incorrect demographic information).

• Review and resolve rejected claims in Waystar clearinghouse portal.

• Request Service tickets to correct payer claim formatting or data points.

• Audit offshore team and calibrate offshore quality auditors.

• Review and process NextGen tasks assigned to the Region Billing task group.

• Analyze NextGen weekly and monthly claim oversight reports for accuracy.

• Coordinate with the Provider Enrollment Team for claim updates, provider data, and effective dates.

• Validate and update payer codes for returned paper claims.

• Research claim formatting issues and submit service requests for system updates.

• Address customer service inquiries from Patient Financial Services.

• Perform additional follow-ups on high-balance accounts by contacting payers, hospitals, or patients as needed.

Must-Have Qualifications:

• 3+ years of experience handling clearinghouse rejections.

• Strong understanding of coverage, dependents, payer portals, demographic updates, claim logic errors, and insurance verification.

• Experience resolving payer rejections and denials for commercial and government payers.

• Familiarity with basic payer rules and regulations

• Strong analytical skills to identify root causes and prevent recurring rejections.

• Ability to identify and implement process improvement opportunities.

• Proficiency in billing and clearinghouse software such as: Waystar, Availity, NextGen.

For California Applicants:

We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO) , and the California Fair Chance Act (CFCA).

This position is subject to a background check based on its job duties, which may include patient care, working with vulnerable populations, access to financial and confidential information, driving, working with heavy machinery, or working in a warehouse or laboratory environment. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.