Revenue Cycle Analyst – Medical Group – E Greenbush, NY - FT
- East Greenbush, NY
- Permanent
- Full-time
- 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
- 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
- High school diploma or equivalency required; Associates degree preferred.
- Effective written and verbal communication skills
- 3+ years' experience in a physician practice or billing office
- 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.