OBGYN Billing Analyst

Jefferson Health Plans • Philadelphia, PA

2d

About The Position

Provides professional and technical billing support to the Department OBGYN. Analyzes all aspects of the Physician/Technical billings to ensure compliance and reimbursement maximization. Responsibilities include coding encounters for diagnosis and CPT codes and ensuring that they are properly entered into the system. Ensure that billing is obtained and charges entered for all providers in each practice site. Reviews physician and hospital billing practices against documentation in the medical record to ensure compliance with all federal, state and third-party billing requirements, rules and regulations. Essential Functions Interacts with co-workers, visitors, and other staff consistent with the values of Jefferson. Review diagnosis codes and CPT procedure codes being used. Assures Physician has used appropriate codes for all outpatient and inpatient encounters. Provide financial counseling to patients; answer inquiries concerning patient bills; Maintain quality assurance so that all charges are accounted for and entered into the billing system by using daily provider schedules. Develops system for tracking inpatient charges. Keep abreast of changes in 3rd party physician reimbursement regulations; develop and implement new billing procedures as needed. Manages the hospital denial reports; research denials; corresponds with appropriate individuals within AEHN or with 3rd parties to rectify. Compose and direct use of appeal letters to specific insurance carriers. Maintains and reports month-end accruals and IDX monthly revenue reports. Review/input of patient demographic and insurance information to ensure charges are generated as appropriate.

Requirements

• High School Diploma (or equivalency)
• 2 years of experience in billing, coding, revenue cycle required

Nice To Haves

• Associate’s Degree preferred
• IDX experience preferred
• Cerner RCX Rules

Responsibilities

• Coding encounters for diagnosis and CPT codes
• Ensuring proper system entry
• Ensuring billing is obtained and charges entered for all providers in each practice site
• Reviewing physician and hospital billing practices against documentation
• Ensuring compliance with federal, state, and third-party billing requirements
• Reviewing diagnosis codes and CPT procedure codes
• Assuring appropriate code usage for outpatient and inpatient encounters
• Providing financial counseling to patients
• Answering inquiries concerning patient bills
• Maintaining quality assurance of charges
• Developing a system for tracking inpatient charges
• Keeping abreast of changes in 3rd party physician reimbursement regulations
• Developing and implementing new billing procedures
• Managing hospital denial reports
• Researching denials
• Corresponding with individuals within AEHN or with 3rd parties to rectify
• Composing and directing use of appeal letters to specific insurance carriers
• Maintaining and reporting month-end accruals and IDX monthly revenue reports
• Reviewing/inputting patient demographic and insurance information

Benefits

• Jefferson offers a comprehensive package of benefits for full-time and part-time colleagues, including medical (including prescription), supplemental insurance, dental, vision, life and AD&D insurance, short- and long-term disability, flexible spending accounts, retirement plans, tuition assistance, as well as voluntary benefits, which provide colleagues with access to group rates on insurance and discounts.
• Colleagues have access to tuition discounts at Thomas Jefferson University after one year of full time service or two years of part time service.
• All colleagues, including those who work less than part-time (including per diem colleagues, adjunct faculty, and Jeff Temps), have access to medical (including prescription) insurance.

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED