Medical Billing Associate - Saratoga Hospital
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 clean claims are sent to payers, and introduction to denial resolution, including initiating appeals or rebilling, is also part of this role. The incumbent will be expected to work independently and meet production standards after onboarding and training, with communication with peers, trainers, and leaders being imperative to success.
Requirements
- High School Diploma/G.E.D.
- Excellent verbal and written communication skills.
- Ability to communicate with internal peers and leadership.
- Demonstrates an ability to learn and understand instruction.
- Ability to effectively prioritize and execute tasks in a high-volume atmosphere.
- Microsoft Office and website knowledge.
- Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties.
- Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose.
- Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.
Nice To Haves
- Associate's Degree
- Prior office experience
- Ability to work independently and within a team
- CCS-Certified Coding Specialist
- Certified Inpatient Coder (CIC) or Certified Outpatient Coder (COC) Upon Hire
- Equivalent combination of relevant education and experience may be substituted as appropriate.
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 information or initiating a dispute or appeal to the payer.
- Collaborate professionally internally or with external departments when needed to resolve edits or denials.
- Recognize payer trends amongst claims editing for similar reasons and communicate these trends to leaders to determine if a systematic update is required.
- Identify payer trends within denials and work with leaders to mitigate these denials where possible, with the goal of minimizing aging AR.
- Provide proper and detailed notation of actions taken on the account, as others will rely on these notes for subsequent follow-up steps.
- Navigate payer websites as needed to obtain information.
- Review, understand, and locate payer policy guidelines for billing or denial resolution.
- Proficiently use 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.
- Perform other duties as assigned.
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Education Level
High school or GED
