Billing Analyst

King County•Chinook Building 401 5th Avenue Seattle, WA

15h•Hybrid

About The Position

We are seeking a qualified Billing Analyst to be responsible for reviewing individual charges and processing claims and denials to maximize patient revenue. The position requires working knowledge of local, state and federal billing requirements, including third party payers. The incumbent must have experience using an automated patient management system, including billing and practice management systems. As the Billing Analyst, you will be responsible processing denials and claims in the Epic Resolute (Billing System). The incumbent will work in billing Workqueues in Epic at an independent pace. The incumbent must have experience using an automated patient management system, including billing and practice management systems. The work environment is fast-paced and flexible. Our Team is a close-knit group that works together in troubleshooting claims and denials in Epic Resolute. Opportunity to work with a fun and positive team and provide healthcare services to the most vulnerable populations. We are seeking a self-motivator that is a quick learner and loves a new challenge. The Business and Revenue Unit (BRU) does billing in Epic Resolute and provides training/support of the Epic Practice Management system to 13 main clinic locations throughout King County, including 3 School Based Health Centers, some satellite clinics and mobile units. We do the billing across multiple divisions - Community Health Services, Prevention and soon will be expanding to include billing for services for JHS and DAJD under the Reentry Demonstration Initiative. Our unit is responsible for maintaining the Epic Resolute (billing) system, enrolling billable providers in contracted health plans, reviewing individual charges, and processing claims and denials to maximize patient revenue. We also provide Epic Practice Management training and support for the front desk staff at the public health clinics. Note: This posting will create a list of qualified candidates that may be considered for selection of additional vacancies of the same position type over the next 6 months.

Requirements

Demonstrated working experience with healthcare insurance billing
Demonstrated working knowledge of Federal and State laws governing insurance billing
Demonstrated experience gathering, researching and analyzing data
Demonstrated problem – solving skills
Demonstrated experience with insurance verification systems
Demonstrated experience with automated systems and software applications
Knowledge of basic accounting principles
Skilled in working under constant time constraints and meeting deadlines
Excellent verbal and written communication skills
Employees are required to protect the privacy and security of protected health information as defined in State and Federal Law.
Public Health relies on office automation (Microsoft Office) and web-based enabled tools, therefore candidates must be proficient and comfortable with computer use to perform functions associated with on-going work.
Employees are required to adhere to OSHA/WISHA guidelines including but not limited to completing their mandatory trainings on time and obtaining required immunizations.
Regular and reliable attendance, effective communication skills, and development of effective working relationships are requirements of all Public Health positions.

Nice To Haves

Demonstrated knowledge of Washington state Medicaid programs and billing requirements
Demonstrated knowledge of Washington state Medicaid client eligibility and benefit packages
Demonstrated knowledge of Federally Qualified Health Center billing requirements
Knowledge of CPT, ICD, and CDT codes
Demonstrated experience with Epic Prelude and Resolute

Responsibilities

Assist with interpretation of private, state and federal billing requirements to assure compliance and optimal revenue, including the Centers for Medicare and Medicaid Services, the Washington State Health Care Authority and contracted managed care organizations.
Coordinate third party payer billing requirements with Public Health staff including clinical, program and business practices staff.
Assist with coding for proper billing and reimbursement.
Coordinate coding issues with certified coder.
Review charges for billing compliance and accurate data collection.
Provides recommendations to ensure billing/revenue requirements are met in an electronic (EHR) environment.
Provide analyses/recommendations to Public Health Centers and/or providers to ensure billable encounters and billing requirements are met.
Process charges and claims for billing to maximize patient generated revenue.
Monitor accounts receivable and resolve aging accounts
Analyze, research and resolve outstanding and/or denied claims.
Analyze, research and resolve guarantor and pended claims.