Medical Billing Analyst

Albany Medical Center•Saratoga Springs, NY

About The Position

The Medical Billing Analyst is an intermediate billing position within the Albany Med Health System Hospital or Physicians Billing Offices. The role focuses on timely follow-up for previously billed accounts that need rebilling, accounts for which the payer has not responded within regulatory guidelines, and accounts with denials that require immediate action or rebuttal. More intricate denials may require a professional narrative and supporting documentation. Assignment focus may vary according to operational needs. The analyst is expected to learn quickly, work independently after onboarding and training, meet production standards, and communicate with peers, trainers, and leaders. The role uses payer websites to identify policies and claim information that may affect timely payment, and works with internal and external departments to resolve billing edits, denials, and accounts receivable issues.

Requirements

High school diploma or GED.
Ability to work independently and as part of a team.
Excellent verbal and written communication skills, including communication 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.
Ability to work under time constraints and deadlines with minimal supervision.
Meet applicable production standards and acceptable QA results after onboarding and training.

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 intricate billing edits, determine what occurred with the original claim, and meet additional requirements for successful rebilling.
Follow up on assigned no-response work queues and contact payers by phone, email, or website platforms as needed.
Locate denials, remittances, payer policies, claim adjudication details, and supporting documentation through payer websites.
Respond to assigned denials by correcting 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 and communicate payer trends affecting claims, denials, or accounts receivable, and work with leaders to mitigate them where possible.
Work billing edits and serve as a resource to Medical Billing Associates as needed.
Document account actions accurately and in detail for subsequent follow-up.
Work independently with minimal supervision, prioritize workload, and meet daily or weekly productivity standards and acceptable quality-assurance results.
Identify accounts aging beyond 60 days that may need placement on payer agendas when normal dispute processes have not resolved them.
Communicate promptly and professionally with outside departments and participate in practices, hospital departments, and revenue-cycle activities at leadership's request.
Develop an understanding of expected reimbursement and leadership reports relevant to assigned work.
Perform other duties as assigned.