Revenue Cycle/ Billing – Ortho Team - Albany
About the position If you are looking for a Revenue/Billing position in Albany, Full time, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. This position is located at 425 New Scotland Avenue, Albany, NY. We are searching for a motivated medical biller for our orthopedics team. Coding a plus but not needed. Insurance knowledge a must. Position reports to office 4 out of 5 days a week and 1 allowed work remote 1 day a week. Position Highlights: Quality of Life: Where career opportunities and quality of life converge Advancement: Strong orientation program, generous tuition allowance and career development Office Hours: Monday - Friday No nights no weekends What you will do: The Revenue Cycle Analyst is responsible for performing a variety of clerical duties related to the efficient and service-oriented operation of a medical practice. Medical billing/insurance background a must. Coding not required but a plus.
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
Requirements
- 3+ years' experience in a physician practice or billing office
- Orthopedics Billing experience required
- High school diploma or equivalency required; Associates degree preferred.
- Effective written and verbal communication skills
- Demonstrated attention to detail, organization & effective time management
- Ability to work independently with little supervision
- Knowledge of CPC
- Knowledge of CPT, CPTII, and ICD10
- Knowledge of insurance carriers
- Solid judgment to escalate issues appropriately
- Advanced knowledge of Microsoft Office, related computer programs & general office machines
- Ability to lift 20 lbs.
Benefits
- Quality of Life: Where career opportunities and quality of life converge
- Advancement: Strong orientation program, generous tuition allowance and career development
- Office Hours: Monday - Friday No nights no weekends
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