Medical Billing Analyst

Albany Medical Center•Hudson, NY

25d

About The Position

The Medical Billing Analyst is an intermediate billing position within the Hospital or Physicians Billing Offices for Albany Med Health System (AMHS). The role focuses on timely follow-up for previously billed accounts that require rebilling, accounts without a payer response within regulatory guidelines, and denials that require prompt action or rebuttal. Assigned denials may be complex and require a professional narrative and supporting documentation. The specific focus may vary based on departmental needs. The analyst is expected to learn quickly, work independently after onboarding and training, meet production standards, communicate with peers, trainers, and leaders, and use payer websites to find relevant policies and claim information. The position also helps identify and communicate payer and department trends affecting accounts receivable, with particular attention to accounts over 60 days old, and collaborates with internal and external departments to resolve billing and follow-up challenges.

Requirements

High school diploma or GED.
Ability to work independently and within 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 meet production standards and work with minimal supervision 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 complex billing edits, determining what occurred on the original claim and what is needed 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, 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 edits, denials, and follow-up challenges.
Identify and communicate payer trends in billing edits and denials to leaders, and work to mitigate them where possible.
Serve as a resource to Medical Billing Associates and be able to work all billing edits.
Document account actions accurately and in detail for subsequent follow-up.
Use Epic, On Base, and other platforms as needed.
Work independently with minimal supervision and within time constraints and deadlines; prioritize workload effectively.
Identify possible approaches to resolving claim challenges.
Meet daily and weekly productivity standards with acceptable quality assurance results.
Identify accounts for payer agendas when they are not resolved through normal dispute processes, focusing on accounts receivable over 60 days old.
Identify department trends requiring management attention and participate in requested initiatives or activities.
Develop an understanding of expected account reimbursement and leadership-provided reports relevant to assigned work.
Perform other duties as assigned.