Billing Analyst

Springfield Clinic•Springfield, MO

About The Position

The Billing Analyst monitors and analyzes the accuracy and integrity of billing and reimbursement processes. The role analyzes billing laws and contract regulations to support efficient billing of third-party payers by Springfield Clinic and completes projects involving denials, billing errors, and reimbursement questions. The position reports to the Billing Compliance Manager. Duties are assigned by that manager, and not all duties may be assigned to every staff member. The role also includes occasional backup for other Billing Compliance Unit staff, compliance with incident-reporting and OSHA policies and required training, excellent customer service in accordance with the SC Way philosophy, and other duties as assigned.

Requirements

High school diploma or GED required; college preferred.
At least three years of insurance billing or review work experience.
Strong analytical and communication skills.
Proficiency with software applications used to perform job duties.
Ability to work independently on assigned duties with minimal supervision.
Ability to build knowledge of laws and regulations through continuing education, including reading manuals, subscriptions, or newsletters and attending in-services or educational conferences.
Manual dexterity for using a calculator and computer keyboard.

Nice To Haves

College education preferred.

Responsibilities

Conduct assigned research projects to support proper reimbursement by third-party payers.
Analyze Medicare and Medicaid regulations and assist with educating providers and staff about compliance with those rules.
Analyze contractual insurance plans to help ensure reimbursement follows contracts and fee schedules.
Complete assigned projects supporting billing compliance with applicable laws and regulations.
Perform assigned Compliance Audit Reports and provide follow-up reporting to the Patient Accounting Coding and Billing Oversight Committee and/or Springfield Clinic Compliance Committee.
Complete provider education projects, which may include face-to-face meetings, educational memos, and participation in orientation sessions.
Assist with maintaining pre-submission claim-editing systems and analyze projects resulting from system reports, as assigned.
Analyze monthly insurance denial reports, as assigned.
Provide occasional backup, as needed, to other Billing Compliance Unit staff members.
Comply with Springfield Clinic incident-reporting policies and procedures and adhere to OSHA and required Springfield Clinic training policies.
Provide excellent customer service and adhere to the SC Way customer-service philosophy.
Perform other duties as assigned.