Revenue Cycle Analyst - Full-time - Hybrid

$38,480 - $51,293/Yr

NY_SPHP87 St. Peter's Health Partners Medical Associates, P.C. - Albany, NY

Full-time - Entry Level

Remote - Albany, NY

10,001+ employees

About the position

The Revenue Cycle Analyst position at St. Peter's Health Partners is a full-time role focused on ensuring the efficient operation of medical billing processes. The analyst will be responsible for monitoring claims, resolving issues, and ensuring timely submission of clean claims to insurance providers. This role emphasizes quality service, effective communication, and adherence to healthcare regulations, all while supporting the organization's mission and core values.

Responsibilities

• Monitor and resolve Claims Work queues, specifically Front End, Referrals & Authorizations, and Clinical Workflow.
• Review denial/rejections and write-off dashboards for trends and provide necessary education to Providers/front end users.
• Ensure all necessary referral documentation is obtained and documented to secure appropriate revenue.
• Run monthly reports to identify outbound referrals and communicate improvement opportunities to the Manager.
• Ensure all billable services are processed within the EMR in a timely manner.
• Submit all billed services to insurances as 'Clean Claims'.
• Review all charges and submit to claims scrubber, working all claims scrubber edits in a timely manner.
• Identify problematic charges for further review to correct coding/billing issues.
• Adhere to productivity/quality guidelines and communicate effectively with other departments.
• Process inpatient charges submitted by providers via interface tool or manual sheets and complete charge reconciliation daily.
• Report any outstanding claims to ensure timely billing and review each claim for appropriate information.
• Identify and review high dollar outstanding balances and ensure Financial Assistance options are offered to patients.
• Act as a Superuser for the site and ensure patient questions are answered while maintaining confidentiality and adhering to HIPAA regulations.
• Perform mandatory in-service training and maintain a clean and safe work environment.

Requirements

• High school diploma or equivalency required; Associates degree preferred.
• Effective written and verbal communication skills.
• 3+ years' experience in a physician practice or billing office.
• Demonstrated attention to detail, organization & effective time management.
• Ability to work independently with little supervision.
• Knowledge of CPC, CPT, CPTII, and ICD10.
• Knowledge of insurance carriers and solid judgment to escalate issues appropriately.
• Advanced knowledge of Microsoft Office and related computer programs.

Nice-to-haves

• Experience with medical billing software and systems.
• Familiarity with healthcare regulations and compliance standards.

Benefits

• Generous tuition allowance for career development.
• Flexible schedule with one work from home day a week.
• Strong orientation program for new employees.