Medical Billing/Revenue Cycle – Ortho Team - Albany

Trinity Health•Albany, NY

10h•Hybrid

About The Position

This position is located at 425 New Scotland Avenue, Albany, NY. If you are looking for a Medical Billing / Revenue Cycle position in Albany, Full time, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. We are searching for a motivated medical biller for our orthopedics team. Coding a plus but not needed. Insurance knowledge a must. Position reports to office 4 out of 5 days a week and 1 allowed work remote 1 day a week.

Requirements

3+ years' experience in a physician practice or billing office
Orthopedics Billing experience required
High school diploma or equivalency required
Effective written and verbal communication skills
Demonstrated attention to detail, organization & effective time management
Ability to work independently with little supervision
Knowledge of CPC
Knowledge of CPT, CPTII, and ICD10
Knowledge of insurance carriers
Solid judgment to escalate issues appropriately
Advanced knowledge of Microsoft Office, related computer programs & general office machines
Ability to lift 20 lbs.

Nice To Haves

Associates degree preferred
Coding a plus

Responsibilities

Responsible to monitor and resolve Claims Work queues, Specifically Front End, Referrals & Authorizations, and Clinical Workflow.
Responsible for monitoring the Trinity Health Front End Metrics and working with Practice Management to identify educational opportunities as necessary.
Responsible for review of 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.
Responsible for running monthly reports to identify any outbound referrals and communicate back to Manager for any improvement opportunities
Ensures all billable services are processed within the EMR in a timely manner.
Ensures all billed services are submitted to insurances as "Clean Claims"
Works within the working queue to review all charges and submit to claims scrubber
Work all claims scrubber edits in a timely basis
Identify any problematic charges for further review to correct coding/billing issues
Adhere to productivity/quality guidelines
Communicate effectively and professionally with other departments within the organization
Work with Revenue Cycle Manager to identify needed feedback to practice locations.
Process inpatient charges submitted by providers via interface tool or manual sheets
Manually enter charges as assigned and complete charge reconciliation daily.
Report any outstanding claims to contact to ensure all claims are billed timely
Review each claim for appropriate information.
Identify and review high dollar outstanding balances and ensure Financial Assistance options are offered to patients and/ or secured by Front End users.
Provide necessary feedback from operational departments to Revenue Integrity team as appropriate
Act as a Superuser for the site and act as a resource, to ensure patient questions are answered.
Maintain patient confidentiality and adhere to HIPAA regulations as appropriate.
Daily TOS reconciliation with front end