Healthcare Billing Analyst
Reporting to the Billing Manager or, in their absence, a designated supervisor, the Billing Analyst will be responsible for the analysis and reporting of the submitted professional medical claims to insurance companies including physicians’ offices, hospitals and residential health care facilities.
Duties and Responsibilities:
- Reviews patients’ bills for accuracy and completeness and obtains any missing information.
- Schedules and coordinates the flow of work within or between departments to expedite project efficiencies.
- Follows up on adjudicated claims, as well as submission of claims.
- Submits and follows up on payer specific appeals.
- Resolves patient and clinic billing enquiries.
- Adheres to pre-established guidelines, specific instructions and training, to effectively perform the functions of the job.
- Writes and review standard operating procedures for common departmental tasks/duties.
- Attends variance meetings and documents problems which occurred on the job in order to facilitate solutions.
- Coordinates interdepartmental meetings pertaining to efficiencies of the role/task.
- Assists accounting staff, finance and legal departments with special projects as needed.
- Analyzes many variables and chooses the most effective course of action quickly.
- Works on additional tasks as requested by Management.
- Answers all patient or insurance telephone inquiries pertaining to assigned accounts.
- Other duties as assigned.
Qualifications and Experience:
A High School diploma or equivalent is required. Knowledge of business and accounting processes, usually obtained from an Associate’s Business Administration, Accounting or Health Care Administration is preferred. A minimum of 1 to 3 years in a medical office setting, preferably in a toxicology laboratory environment is required, together with knowledge of insurance guidelines, especially Medicare and state Medicaid.
Skills and Competency:
The successful candidate will have the skills and competency to communicate with people of all levels of the organization, patients and external agencies. They will be agreeable and professional at all times, building relationships with the people with whom they work in order to clarify and achieve results identified. Accurate information gathering is essential as is the ability to work to tight deadlines and prioritize conflicting demands whilst working effectively.
They will have the ability to listen actively when spoken to and effectively communicate their thoughts to others, being sensitive to religious, ethnic and cultural differences in others and showing respect and empathy. They will be able to work alone but also in a team, with fellow staff, in the business setting and will actively seek out advice and/or guidance in order to solve problems. The Candidate will have good time management skills and will actively seek to accomplish tasks and be able to use a variety of methods and ideas to solve problems whilst also being open to suggestions from others in order to find solutions. They will be able to adapt to change and uphold safety standards whilst maintaining good attention to detail and accuracy.