Overall Purpose of the Role The mission of the Beacon Hospital is to provide exceptional patient care in an environment where quality, respect, caring and compassion are at the core of our practice.
This must include all our patient dealings and Patient Accounts processes.
The Insurance Collections Analyst plays a critical role in protecting hospital revenue by reviewing unpaid and pended insurance claims, ensuring that claims are clinically supported, contractually compliant, accurately billed, and facilitating prompt payment through effective follow-up and resubmission where required.
The role requires a strong understanding of clinical documentation, insurance contracts, and billing rules, and an ability to identify and resolve issues that prevent full reimbursement.
Key Responsibilities and Deliverables Review pended, partially paid, and unpaid insurance claims to identify clinical, contractual, or billing-related barriers to payment.
Assess claims against insurance contracts, benefit rules, and agreed tariffs to confirm that initial billing complied with contractual requirements.
Analyse insurer payment decisions to determine underpayments, rejections, or requests for further information.
Compile, review, and submit appropriate clinical documentation to support claim resubmission, appeals, or payment queries.
Work closely with clinical teams, medical records, and consultants to obtain accurate and complete documentation to support claims.
Ensure claim resubmissions are timely, accurate, and financially optimised, with a clear focus on maximising appropriate reimbursement.
Maintain detailed and accurate system notes outlining claim status, actions taken, and next steps.
Demonstrate a strong awareness of the financial impact of delayed or incomplete claim follow-up on hospital cash flow.
Identify recurring claim issues or documentation gaps and feedback quality improvement opportunities to billing and finance teams.
Maintain professional working relationships with health insurers to efficiently resolve claim queries and outstanding balances.
Use hospital IT systems effectively to support claim review, documentation tracking, and insurer correspondence.
Participate in audits, service evaluations, and process reviews aimed at strengthening claim quality and revenue protection.
Ensure full compliance with hospital policies, data protection requirements, and confidentiality standards.
Contribute to departmental objectives, meetings, and continuous improvement initiatives.
Person Specification Qualifications Third-level qualification in business, finance, health administration, or a medicalrelated field desirable but not essential.
Proficiency in MS Excel, Word, Power BI, and related applications.
Experience Minimum of 2 years' experience in an administrative, financial, or healthcare-related role.
Previous experience in a hospital, insurance, or healthcare billing environment is advantageous.
Job-Specific Competencies and Knowledge Strong analytical and problem-solving skills, particularly in reviewing financial and clinical information.
Ability to interpret insurance contracts, claim outcomes, and payment explanations.
Proven capability to work to financial targets and strict timeframes.
High level of accuracy and attention to detail when reviewing claims and documentation.
Confident and professional communicator with insurers, clinicians, billing teams, and hospital management.
Strong understanding of confidentiality, discretion, and data protection requirements.
Ability to manage workload in a high-volume, deadline-driven environment.
Personal Competencies Self-motivated with a strong sense of accountability and initiative.
Excellent organisational and prioritisation skills.
Ability to work effectively both independently and as part of a team.
Positive, solutions-focused approach to resolving complex issues.
Fluent written and spoken English.
All posts in Beacon Hospital require a high level of flexibility to ensure the delivery of an effective and efficient service.
Therefore, the post holder will be required todemonstrate flexibility as and when required by their manager or hospital management.
This job description is intended to be an outline of the areas of responsibility and deliverables at the time of its writing.
As the Hospital and the post holder develop, this job description may be subject to review in light of the changing needs of the Hospital.