Medical Billing Analyst - Glens Falls Hospital
$46,947–$65,726 year
On-siteNew York City, New York, United States
Job Summary
Resolve intricate billing edits and follow up on accounts with no payer response or denials requiring immediate action and rebuttal. Navigate payer websites to locate policies impacting timely payment, then respond to denials by updating claim information or submitting appeals with supporting documentation. Collaborate professionally with coding, patient access, and leadership to mitigate denial trends and minimize aging accounts receivable. Prioritize workload under time constraints while maintaining daily productivity standards and acceptable QA results. Work independently with minimal supervision using Epic and On Base platforms to ensure correct payments are received.
Required Qualifications
- High School Diploma/G.E.D.
- Ability to learn quickly and work independently
- Ability to use payer websites to locate payer policies
- Ability to work independently
- Ability to meet production standards
- Ability to communicate with peers, trainers, and leaders
- Ability to resolve billing edits
- Ability to follow up on No Response WQs
- Ability to communicate with payers via phone, email, or website platforms
- Ability to locate denial or remittances via payer websites
- Ability to respond to denials received on accounts
- Ability to re-bill claims or submit appeals with supporting documentation
- Ability to collaborate professionally internally or with external departments
- Ability to identify and present payer trends amongst claims
- Ability to communicate and work with leaders to mitigate denials
- Ability to minimize aging AR
- Ability to provide proper and detailed notation of actions taken on accounts
- Ability to navigate payer websites to obtain information
- Ability to review, understand, and locate payer policy guidelines
- Ability to locate claim adjudication details with supporting documentation
- Proficient use of Epic, On Base, and other platforms
- Ability to work independently and under time constraints and deadlines with minimal supervision
- Ability to prioritize workload in an effective manner
- Ability to articulate possible avenues to resolve claim challenges
- Ability to meet daily/weekly productivity standards with acceptable QA results
- Ability to identify accounts that need to be placed on payer agendas
- Ability to concentrate on AR > 60 days
- Ability to identify and communicate payer trends negatively impacting overall AR
- Ability to communicate with outside departments to resolve billing or follow-up challenges
- Ability to identify department trends that need to be brought to Management
- Ability to build an understanding of expected reimbursement on accounts
- Ability to build an understanding of reports provided by leadership
- Consistent and responsive communication with Patient Access and Coding
- Excellent verbal and written communication skills
- Ability to communicate with internal peers and leadership
- Demonstrates an ability to learn and understand instruction
- Ability to effectively prioritize and execute tasks in a high-volume atmosphere
- Microsoft Office and website knowledge
Desired Qualifications
- Associate's Degree
- Medical Billing or claims knowledge
- Ability to work independently and within a team
- CCS-Certified Coding Specialist
- Certified Inpatient Coder (CIC)
- Certified Outpatient Coder (COC)
- Equivalent combination of relevant education and experience
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