Analyst-Insurance Coverage Quality

Job Summary

Job Summary
The Insurance Coverage Quality Analyst is responsible for ensuring accurate and timely insurance 
coverage updates across patient accounts. This role focuses on improving coverage validation, reducing 
self-pay balances, and minimizing billing errors through proactive account reviews, customer service 
engagement, and workflow optimization.

Required Population Served

Job Responsibilities

Job Responsibilities
• Add and correct insurance coverage on patient accounts.
• Perform retro authorizations and rebill accounts as needed.
• Validate coverage for discharged patients.
• Conduct daily, future, and post-discharge self-pay scrubs (30, 60, and 90-day).
• Review eligibility denials for potential coverage by other payers and DSH eligibility.
• Manage Out-of-Network (OON) work queues and ensure all commercial insurances are added for 
OON accounts.
• Monitor and resolve failed billing account work queue errors related to coverage effective dates 
and validation checks.
• Provide staff education on coverage processes and best practices.
• Work closely with facility teams on First Source identified coverage and in-house insurance 
changes.
• Completes additional assignments as needed.

Specifications

Experience
Description Minimum Required Preferred/Desired

Minimum 2 years in insurance 
verification, billing, or revenue 
cycle operations. Familiarity with 
Hospital and Physician Billing 
workflows.

Education
Description Minimum Required Preferred/Desired
Associate’s or Bachelor’s degree 
in Healthcare Administration, 
Business, or related field 
preferred.

Training
Description Minimum Required Preferred/Desired

Special Skills
Description Minimum Required Preferred/Desired
Strong attention to detail and 
analytical skills. Excellent 
communication and customer 
service abilities. Proficiency in 
healthcare billing systems and 
work queue management.

Licensure
Description Minimum Required Preferred/Desired