RCM Billing Analyst

Pediatrix•,

About The Position

We have an exciting opportunity for a Revenue Cycle Management (RCM) Billing Analyst to join our team. Pediatrix Medical Group is a physician lead organization, and we are one of the nation’s largest providers of prenatal, neonatal and pediatric services. Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere. We offer a diverse range of opportunities, competitive salaries and benefits, and a commitment to clinical excellence, we are confident that you'll love being a part of the Pediatrix team.

Requirements

Associate's degree (A. A.) or equivalent from two-year college or technical school
2 years related experience and/or training; or equivalent combination of education and experience.
Word
Excel
Crystal
OBR
GPMS
RDS
BabySteps
SounData
Onbase
Master Database

Responsibilities

Analyzing, researching and resolving issues related to the creation and submission of paper and electronic claims.
Works with the Business Systems Department to create effective clearinghouse edits which respond to errors generated from electronic claims submissions.
Monitors claim errors until resolved.
Identifies opportunities for new edits based on billing analysis.
Daily review Claims Manager, OBR and GPMS edit reports.
Review errors with associates and re-train as necessary. Monitor errors until resolved.
Identify opportunity for new edits based on billing analysis.
Validate daily import of RDS/BS interface.
Balance Hash Totals and identify any skipped and/or duplicated batches.
Identify and report to IS any system issues.
Work with IS to achieve timely resolution of all daily issues.
Validate weekly uploads from SounData interface.
Monitor daily EPM Exception report and work with Practice to resolve any open issues.
Balance Hash Totals and identify any failed transactions.
Identify and report any system issues to IS. Work with IS to achieve timely resolution of all outstanding daily issues.
Complete daily edit reports for OnBase scanning. QC scanned batches for validation of completeness.
Continuously monitor and audit the billing control processes and operations.
Perform coding clean-up when required.
Perform end of month process.
Perform testing for all system upgrades. Validate upgrades in production once implemented.
Maintain strict confidentiality in accordance with HIPAA regulations and Company policy.
Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.