Medical Billing Analyst

Albany Medical Center•Saratoga Springs, NY

3d•$46,947 - $65,726

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 requiring rebilling, accounts without a payer response within regulatory guidelines, and denied claims requiring prompt action or rebuttal. Assigned denials may be complex and require a professional narrative and supporting documentation to overturn. Work assignments may focus on one or more of these areas depending on business needs. The analyst is expected to learn quickly, work independently after onboarding and training, meet production standards, and communicate effectively with peers, trainers, leaders, and other departments. The role uses payer websites to research policies and claim adjudication details, resolves billing edits and denials, identifies payer and departmental trends, and supports efforts to reduce aging accounts receivable. The position requires appropriate handling of sensitive information, including HIPAA-protected health information, in accordance with AMHS policies and applicable laws.

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.
Demonstrated ability to learn and understand instructions.
Ability to prioritize and execute tasks effectively in a high-volume environment.
Knowledge of Microsoft Office and websites.

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, understand the history of previously billed claims, and determine what is needed to rebill successfully.
Follow up on assigned no-response work queues by contacting payers by phone, email, or web platforms and locating denials or remittances as needed.
Respond to assigned denials by correcting claim information and rebilling 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 billing edits or denials, and work with leaders to mitigate them.
Serve as a resource to Medical Billing Associates and be able to work all billing edits.
Document account actions accurately and in detail to support subsequent follow-up.
Navigate payer websites to review payer policies, obtain information, and locate claim adjudication details and supporting documentation.
Use Epic, On Base, and other required platforms proficiently.
Work independently with minimal supervision, manage time constraints and deadlines, prioritize workload effectively, and identify possible ways to resolve claim challenges.
Meet daily and weekly productivity standards while achieving acceptable quality assurance results.
Identify accounts, particularly those with accounts receivable older than 60 days, for payer agendas when they are not resolving through the normal dispute process.
Communicate payer trends that negatively affect overall accounts receivable and identify departmental trends for management review.
Communicate promptly and professionally with outside departments to resolve billing and follow-up challenges.
Participate in addressing departmental practices or trends at leadership's request.
Develop an understanding of expected reimbursement and use leadership reports relevant to assigned tasks.
Perform other duties as assigned.
Protect sensitive information by limiting access, use, and disclosure to the minimum necessary and following AMHS policies and standards.