Claims Research Analyst - Physicians' Billing

• Contacts third party payers as needed to resolve billing problems/claims processing delays.
• Exemplifies Guest and Staff Relations standards in all activities in areas of service, resource utilization, high quality outcomes and effective communication and holds staff accountable for conformity with those standards in all activities.
• Maintains billing manuals and reference documents for assigned third party carriers.
• Processes high volume claim submissions with an error rate of 10% and less.
• Recommends and assists in implementation of manual and automated billing processes to enhance claim generation and submission process.
• Researches and requests necessary billing information and documentation from provider/division billing contact/patient.
• Resolves all No Activity invoices accurately and in a timely manner.
• Responds to incoming mail from insurance carriers.
• Reviews and resolves claim issues such as edits and registration edits in a timely manner.
• Reviews claim forms to meet billing requirements as dictated by third party payers.
• Reviews, processes, or reassigns appeals, charge correction, coding and provider enrollment rejections as required to achieve successful claim reimbursement.
• Serves as resource to others related to assigned insurance carriers as needed.
• Updates accounts in billing system.
• Contributes to the achievement of established department goals and objectives and adheres to department policies, procedures, quality standards and safety standards. Complies with governmental and accreditation regulations.

• High School Diploma or GED equivalent required

• 1-2 years medical billing environment required
• GE IDX experience preferred

• Knowledge of accounts receivable practices.
• Strong organizational skills with the ability to process high volume services, with accuracy on a daily basis.
• Skills in using computer and calculator.
• Ability to examine documents for accuracy and completeness and prepare claims and other records according to detailed instructions.
• Ability to work and thrive in team oriented, production and deadline driven work environment.
• Verbal and written communication.

• Strong emphasis on teamwork - our associates feel connected to each other and our mission as an organization. In return, our effective team environment generates positive patient outcomes and high associate satisfaction ratings that exceed the national benchmark.
• Strategic focus on equity, inclusion, & diversity - we are committed to equity for all people and communities. We continue to build a diverse and inclusive workplace where people feel a sense of belonging and the ability to contribute to equitable care delivery and improved community health outcomes at all levels of the organization.
• Comprehensive total rewards package - including competitive pay, generous paid time off, great health and wellness benefits, retirement savings, education assistance, and so much more.
• More career opportunities closer to home - as the largest healthcare provider in the Baltimore-Washington, D.C. region, there are countless opportunities to grow your career and fulfill your aspirations.

MedStar Health