Medical Billing Associate - Glens Falls Hospital

Albany Medical Center • Glens Falls, NY

21h

About The Position

The Medical Billing Associate is a position located within the Hospital or Physician Billing Offices. The role 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 as well as some introductory payer denials. Claims must meet the regulatory requirements as well as 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. Initiating an appeal or rebilling the claim to address the denial is paramount to receiving payment. The incumbent will be expected to work independently and meet production standards after the prescribed onboarding and training is concluded. Communication with peers, trainers, and leaders will also be imperative to success. We have positions open at Albany Med, Saratoga Hospital and Glens Falls Hospital in the Patient Billing Department

Requirements

• High School Diploma
• Ability to work independently and under time constraints and deadlines and with minimal supervision. to prioritize workload in an effective manner.

Responsibilities

• Resolve all billing edits found in the assigned WQs.
• Respond to denials received on accounts as assigned. This may require a re-billing of a claim after updating the correct information or it may require the initiation of 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. 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. Goal to minimize aging AR.
• Proper and detailed notation of actions taken on the account. Others will rely on those notes when taking the next step on the account follow up.
• Payer Website navigation 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 and with minimal supervision. to 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: High school or GED