Medical Billing/Revenue Cycle – Clifton Park

Trinity Health•Clifton Park, NY

1d•$20 - $27•Hybrid

About The Position

The Revenue Cycle Analyst performs clerical and revenue-cycle duties that support the efficient, service-oriented operation of a medical practice. The role focuses on medical billing and insurance claims, including monitoring and resolving claims work queues, reviewing charges and claims, processing billable services through the EMR, and ensuring claims are submitted accurately and promptly. Orthopedics billing experience and insurance knowledge are required; coding is not required but is a plus. The position is based at 1 Tallowood Drive in Clifton Park, New York. It reports to the office four days a week and may be performed remotely one day a week after training. The schedule is Monday through Friday, with no nights or weekends. The role reports to the Revenue Cycle Manager and serves as a site superuser and resource for patient questions.

Requirements

At least 3 years of experience in a physician practice or billing office.
Orthopedics billing experience.
High school diploma or equivalency.
Effective written and verbal communication skills.
Attention to detail, organization, and effective time management.
Ability to work independently with little supervision.
Knowledge of CPC.
Knowledge of CPT, CPT II, and ICD-10.
Knowledge of insurance carriers.
Sound judgment and ability to escalate issues appropriately.
Advanced knowledge of Microsoft Office, related computer programs, and general office machines.
Ability to lift 20 pounds.

Nice To Haves

Associate degree preferred.
Coding knowledge or experience is a plus.

Responsibilities

Monitor and resolve claims work queues, especially Front End, Referrals and Authorizations, and Clinical Workflow.
Monitor Trinity Health Front End Metrics and work with Practice Management to identify educational opportunities.
Review denial, rejection, and write-off dashboards for trends and provide necessary education to providers and front-end users.
Obtain and document referral materials needed to secure appropriate revenue.
Run monthly reports to identify outbound referrals and communicate potential improvement opportunities to the Manager.
Ensure billable services are processed in the EMR in a timely manner and billed services are submitted to insurers as clean claims.
Review charges in the working queue and submit them to the claims scrubber.
Resolve claims scrubber edits promptly and identify problematic charges for further review and correction of coding or billing issues.
Adhere to productivity and quality guidelines.
Communicate effectively and professionally with other organizational departments.
Work with the Revenue Cycle Manager to identify feedback needed by practice locations.
Process inpatient charges submitted by providers through an interface tool or manual sheets.
Enter charges manually as assigned and complete daily charge reconciliation.
Report outstanding claims to the appropriate contact to ensure timely billing.
Review each claim for appropriate information.
Identify and review high-dollar outstanding balances and ensure financial assistance options are offered to patients or secured by front-end users.
Provide operational feedback to the Revenue Integrity team as appropriate.
Act as the site's superuser and resource, helping ensure patient questions are answered.
Maintain patient confidentiality and comply with HIPAA regulations.
Complete daily TOS reconciliation with the front end.