This job has closed.

Planned Parenthood of Metropolitan Washington, DC, Inc. · 1 day ago

Billing Analyst II

United States

Full-time

Remote

Mid, Senior Level

$65K/yr - $85K/yr

3+ years exp

Planned Parenthood of Metropolitan Washington, DC, Inc. is seeking a Billing Analyst II to support its Revenue Cycle activities. This role involves overseeing complex billing processes, conducting team training, and ensuring accurate reimbursement for medical services while leading a team of reimbursement specialists.

Hospital & Health Care

Responsibilities

Handle high level billing tasks, including complex medical claims, appeals, and disputed charges

Review and verify claim information for accuracy, completeness, and adherence to payers for reimbursement

Utilize comprehensive understanding of claim denials to conduct appropriate claim follow-up on all open A/R to ensure prompt adjudication

Ensure accuracy of billing data and compliance with local, state, and federal regulations, as well as payer -specific regulations

Assist in the development and implementation of policies, procedures, and workflows to improve efficiency

Work closely with coding, front office, clinical teams, and third-party vendors to resolve billing discrepancies and denials

Creation of claim projects with insurance companies and follow through on projects to ensure resolution

Provide guidance, mentorship, and supervision of reimbursement specialists

Perform daily ERA, EOB, and patient payment posting

Reconcile payments posted in Epic to banking deposit logs

Submit invoices for participating grant programs

Submit daily electronic and paper claim files, and correct all claim and charge review edits, warnings and errors; run statement files; and download ERAs/EOBs as needed

Review and monitor clearinghouse claim errors and global payer rejections for possible system edits or payer updates

Prioritize workflow for reimbursement specialists to ensure the revenue cycle team is completing all necessary tasks

Daily review of billing work queues

Credit balance review and processing

Insurance benefit verification

Analyze payer denial trends and payer coding requirements to ensure payment of claims

Ensure month-end activities are completed in a timely manner and that month-end reconciliation is accurately completed

Ensure the affiliate’s claim KPIs are satisfied

Participate in Revenue Cycle Team meetings/conference calls, and provide the necessary reporting, feedback, and training required to improve processes

Serve as an active agent on the billing line

Attend PPMW and PPFA training as well as other assigned training to improve knowledge base and claim efficiency

Follow up on denied claims with payers

Patient statement processing

Assistance with credentialing related inquiries and updates

Complete special projects as needed

Other responsibilities as assigned