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St. Peter's Health Partners · 1 week ago

Revenue Cycle / Billing Analyst – Ortho Team - Albany - FT

Albany, NY

Full-time

Onsite

Mid Level

$18.50/hr - $24.66/hr

3+ years exp

St. Peter's Health Partners is dedicated to providing compassionate care and is seeking a motivated Revenue Cycle/Billing Analyst for their Orthopedics Team in Albany, NY. The role involves performing clerical duties related to medical billing, monitoring claims, and ensuring the efficient operation of the medical practice.

DentalFitnessHealth CareHealth DiagnosticsHospital

Responsibilities

Responsible to monitor and resolve Claims Work queues, Specifically Front End, Referrals & Authorizations, and Clinical Workflow

Responsible for monitoring the Trinity Health Front End Metrics and working with Practice Management to identify educational opportunities as necessary

Responsible for review of denial/ rejections and write off dashboards for trends and provide necessary education to Providers/ front end users

Ensure all necessary referral documentation is obtained and documented to secure appropriate revenue

Responsible for running monthly reports to identify any outbound referrals and communicate back to Manager for any improvement opportunities

Ensures all billable services are processed within the EMR in a timely manner

Ensures all billed services are submitted to insurances as "Clean Claims"

Works within the working queue to review all charges and submit to claims scrubber

Work all claims scrubber edits in a timely basis

Identify any problematic charges for further review to correct coding/billing issues

Adhere to productivity/quality guidelines

Communicate effectively and professionally with other departments within the organization

Work with Revenue Cycle Manager to identify needed feedback to practice locations

Process inpatient charges submitted by providers via interface tool or manual sheets

Manually enter charges as assigned and complete charge reconciliation daily

Report any outstanding claims to contact to ensure all claims are billed timely

Review each claim for appropriate information

Identify and review high dollar outstanding balances and ensure Financial Assistance options are offered to patients and/ or secured by Front End users

Provide necessary feedback from operational departments to Revenue Integrity team as appropriate

Act as a Superuser for the site and act as a resource, to ensure patient questions are answered

Maintain patient confidentiality and adhere to HIPAA regulations as appropriate

Daily TOS reconciliation with front end

Qualification

Medical billing experienceInsurance knowledgeOrthopedics experienceCPTCPTIIICD10CPCInsurance carriersAdvanced Microsoft OfficeEffective communication skillsAttention to detailTime managementWork independently