Medical Billing Analyst - Glens Falls Hospital

Albany Medical Center•Glens Falls, NY

5d•$46,947 - $65,726

About The Position

The Medical Billing Analyst is an intermediate billing position within the Hospital or Physicians Billing Offices for the Albany Med Health System. The role focuses on timely follow-up for previously billed accounts that need rebilling, accounts without a payer response within regulatory guidelines, and denials requiring prompt action or rebuttal. More complex denials may require a professional narrative and supporting documentation. The position’s specific focus may vary according to resource needs. The analyst is expected to learn quickly, work independently, meet production standards after onboarding and training, and communicate effectively with peers, trainers, and leaders. The role uses payer websites to research policies and claim adjudication details, resolves billing edits and denials, follows up on aging accounts receivable, and identifies payer and department trends. The position requires careful account documentation, effective workload prioritization, and collaboration with internal and external departments. The analyst must protect sensitive information, including HIPAA-protected health information, in accordance with applicable laws and organizational policies.

Requirements

High school diploma or GED.
Ability to work independently and as part of a team.
Excellent verbal and written communication skills.
Ability to communicate with internal peers and leadership.
Ability to learn and understand instruction.
Ability to prioritize and execute tasks effectively in a high-volume environment.
Knowledge of Microsoft Office and websites.
Protect sensitive information and follow applicable information-access and confidentiality requirements.

Nice To Haves

Associate's degree.
Prior office experience.
Medical billing or claims knowledge.
CCS (Certified Coding Specialist), CIC (Certified Inpatient Coder), or COC (Certified Outpatient Coder) certification upon hire.
Equivalent combinations of relevant education and experience may be substituted as appropriate.

Responsibilities

Resolve assigned complex billing edits on previously billed claims and identify what is required for successful rebilling.
Follow up on assigned No Response work queues and contact payers by phone, email, or website platforms as needed.
Locate payer denials, remittances, claim adjudication details, supporting documentation, and applicable policy guidelines on payer websites.
Respond to assigned denials by correcting information and rebilling claims or submitting appeals with supporting documentation.
Collaborate professionally with internal and external departments, including Coding and Patient Access, to resolve billing edits and denials.
Identify payer trends among billing edits and denials, communicate them to leaders, and work to mitigate their impact.
Serve as a resource to Medical Billing Associates and work all billing edits as expected for the role.
Document account actions properly and in detail so others can continue follow-up effectively.
Use Epic, On Base, and other platforms as needed.
Work independently with minimal supervision, meet deadlines and productivity standards, achieve acceptable quality assurance results, and prioritize workload effectively.
Identify accounts aging beyond 60 days that should be placed on payer agendas because normal dispute processes have not resolved them.
Communicate payer trends that negatively affect accounts receivable and identify department trends for management review.
Communicate promptly and professionally with outside departments to resolve billing and follow-up challenges.
Develop an understanding of expected reimbursement and leadership-provided reports relevant to assigned tasks.
Participate in department-related activities at leadership’s request.
Perform other duties as assigned.