Position Overview:
Reporting to the Billing Manager, the Billing Analyst is responsible for the oversight of the offshore billing team. They will complete routine audits on charge entry, provide process workflows, feedback, instruction, and guidance to the team. They will manage an escalation queue to ensure timely responses and outcomes resulting in clean claim submissions.
Responsibilities:
- Work with the offshore team to ensure timely and accurate charge entry.
- Manages the exceptions queue for all items escalated by the offshore team for additional review. This includes potential user table updates, net revenue adjustment variances, and more.
- Creates and communicates continuous updates on process workflows for internal and external employees.
- Completes Q/A reviews to identify training needs for system education, industry updates and changes in billing department processes.
- Oversight for billing specifications for all client payers in assigned region, which includes communication of specifications to the offshore team, training on requirements, and provision of tools and resources.
- Routine audits of claim submissions sent electronically and via paper with the appropriate attachments.
- Assist in developing new Tools to streamline processes.
- Actively involved in End of Month processes to ensure all revenue is captured with claims transmitted with the appropriate attachments.
- Other tasks, projects, and training as needed.
Required Skills:
Requirements:
- 2-5 years of charge entry experience. Orthopedic/Pain management/ Ambulatory Surgery Center experience is highly preferred.
- Sound judgment and strong skills with respect to interpersonal relations, critical thinking, problem solving and analysis.
- The ability to communicate effectively, both verbally and in writing, with internal and external clients.
- Be able to multi-task and handle competing priorities while meeting or exceeding deadlines.
- Ability to work independently and as a member of the team.
- Ability to identify and resolve complex client problems.
- Knowledge or experience working with a variety of health care insurance payers is preferred.
- Proficient in Microsoft Office including Excel and Outlook.
- Advantx, Vision, HST, Waystar experience preferred.
- High School Diploma or equivalent.