Medical Billing Associate - Saratoga Hospital

Albany Medical Center • Glens Falls, NY

1d • $46,215 - $60,080 • Onsite

About The Position

The Medical Billing Associate position is located within the Hospital or Physician Billing Offices and is centered around the timely and efficient billing and follow-up of medical claims throughout the Albany Med Health System (AMHS). This role focuses on pre-billing edits and introductory payer denials, ensuring claims meet regulatory requirements and specific payer policies. The edits are in place to ensure that clean claims are sent to the payers. Introduction to denial resolution is also part of this role, which may involve initiating an appeal or rebilling the claim. The incumbent will be expected to work independently and meet production standards after the prescribed onboarding and training. Communication with peers, trainers, and leaders will also be imperative to success.

Requirements

• Ability to work independently and under time constraints and deadlines and with minimal supervision.
• Ability to prioritize workload in an effective manner.
• Meet daily/weekly productivity standards with acceptable QA results.
• Proficient use of Epic, On Base, and other platforms as needed.
• Review, understand, and locate payer policy guidelines for billing or denial resolution.
• HIPAA Protected Health Information knowledge

Nice To Haves

• Introduction to denial resolution is also part of this role.
• Initiating an appeal or rebilling the claim to address the denial is paramount to receiving payment.

Responsibilities

• Resolve all billing edits found in the assigned WQs.
• Respond to denials received on accounts as assigned, which may require re-billing a claim after updating correct information or initiating a dispute or appeal to the payer.
• Collaborate professionally internally or with external departments when needed to resolve the edit or denial.
• Recognize payer trends amongst the claims that are editing for similar reasons and communicate those trends to leaders within the department to determine if a systematic update is required.
• Identify payer trends within the denials and work with leaders to mitigate those denials where possible.
• Minimize aging AR.
• Provide proper and detailed notation of actions taken on the account.
• Navigate payer websites as needed to obtain information.
• Review, understand, and locate payer policy guidelines for billing or denial resolution.
• Proficient use of Epic, On Base, and other platforms as needed.
• Ability to work independently and under time constraints and deadlines with minimal supervision.
• Prioritize workload in an effective manner.
• Meet daily/weekly productivity standards with acceptable QA results.
• Other duties as assigned.

Benefits

• Excellent health care coverage with no copay at Albany Medical Center providers
• A wide array of services and programs to support emotional, physical, and mental wellbeing

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: No Education Listed