Patient Accounting Analyst

Bronson Healthcare

2d•Onsite

About The Position

Performs duties necessary to facilitate payment from third party payers and coordinate the work of the payer team Reimbursement Specialists. This includes correct billing, statusing and collection from third parties, posting third party payments (if applicable), computing correcting reimbursement, processing incoming and outgoing correspondence, and maintaining a working knowledge of current contracts and government regulations for multiple entities. Employees providing direct patient care must demonstrate competencies specific to the population served.

Requirements

High school diploma or general education degree (GED) required.
5 years experience in medical billing and receivables management required.
Successfully pass EUPA's for all Epic applications associated with position within the first 90 days in the position.
Excellent oral, written, organization and interpersonal skills.
Strong computer and general office equipment knowledge required, including relevant computer programs (e.g. Excel).
Knowledge of medical terminology, ICD-9 and CPT-4 coding, National Billing forms, third-party payers, managed care, reimbursement and regulatory compliance required.
Ability to type 45 words per minute.
Critical to this position is understanding the revenue cycle and the importance of evaluation & securing all appropriate financial resources for patients to maximize reimbursement to the health system.
Ability to maintain a self-directed, mature, disciplined approach to completing work duties.
Must be able to effectively teach new skills and processes and act as a team motivator, consistently challenging team members to higher levels of performance.
Must be able to act as a mentor to less experienced members of the team.
Must be able to quickly analyze communication style based on nature and approach of verbal inquiry.

Nice To Haves

Associate's degree in Business or Finance preferred.

Responsibilities

Accountable for ensuring claims are compliant with all payer specifications; State, Federal and HIPAA regulations.
Prepares documentation to maximize reimbursement.
Analyze assignment of all CPT-4, ICD-9, UB04 and charges for accuracy and to maximize reimbursement.
Critically analyze and process third party and internal information requests and rejections in an effort to resolve accounts receivable.
Critically analyze and process documents for resolution of third party liabilities, outstanding credits and un-billed accounts.
Make all necessary posting, adjustments and refunds to accounts and critique contractual allowances and other arrangements.
Responsible for complete understanding and application of current contracts and governmental regulations including referrals for legal intervention for multiple entities.
Proficient in the revenue cycle process via multiple computer systems including but not limited to: STAR, EC2000, EPIC, SSI, Compliance Advisor, Medicare, Blue Cross, GLMI Home Health Billing system, CPR+ Home Infusion Billing system, etc.
Provides for coverage, answers concerns in the absence of manager in short staff situations
Assume team leadership independently identifying potential improvement opportunities that could be put into practice in the day-to-day work of each payer team.
Keeping abreast of changes in payer regulations and trends in the field of billing and collections
Assisting team manager in directing general work flow of team
Coordinating and facilitating work of other team members
Assisting in gathering and summarizing relevant statistics per designated metrics (e.g. A/R dollars, A/R days, claims denied) on a regular basis
Developing and maintaining detailed knowledge of complex payer regulations and requirements for multiple payers
Acting as “team expert” with regard to specific regulations and billing/follow up issues
Responsible for recommending and developing team-specific modifications to all billing systems
Acting as team educator and trainer, participating in external organizations or training sessions and relate information back to team members.
Assists with team and/or individual training and orientation
Demonstrates exceptional ability and willing ness to take on new and additional responsibilities. Embraces new ideas and cultural differences while managing competing priorities.