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Job description
Advanced Senior Billing Analyst
Join a dynamic healthcare finance team as a Senior Billing Analyst, where you will play a crucial role in managing customer billing, collections, and accounts receivable processes. This position requires a detail-oriented professional with a strong understanding of medical insurance claims and payer contracts.
Essential Responsibilities
Process medical insurance claims for assigned payers, ensuring accurate follow-up to final reimbursement.
Maintain working knowledge of payer contracts, member co-pays, deductibles, co-insurance, and eligibility requirements to verify remittance advices.
Respond to payer denials related to diagnosis and procedure codes or contractual issues, ensuring necessary information is transmitted for payment processing.
Analyze and report repetitive denials to management, recommending corrective actions.
Resolve account discrepancies including credit balances, payment transfers, audits, corrected claims, and insurance over/under payments.
Communicate with insurance payers to resolve patient account issues.
Document all actions taken on patient accounts within the accounting system.
Ensure all required billing documentation is complete and follow up with physicians as needed.
Generate billing statements, submit accurate claims, and file secondary or tertiary insurance claims for co-payments and deductibles.
Prepare and submit manual and electronic claims daily.
Collect payments promptly and resolve payment issues.
Respond professionally to customer inquiries.
Adhere to privacy and security regulations regarding Protected Health Information (PHI).
Maintain effective communication and professional relationships with patients, team members, physicians, and external agencies.
People Management
This role does not include direct people management responsibilities.
Education and Experience
High school diploma or GED required.
3-5 years of experience in facility billing, with recent Medicare insurance billing experience.
Strong knowledge of Medicare policies, including Medical Necessity, LCD/NCD, and the Medicare website and Learning Network.
Experience with insurance follow-up on DDE/C-SNAP.
Preferred Qualifications
No additional preferred education or certifications required.
Skills and Abilities
Excellent writing, computer (Microsoft Word, PowerPoint, Excel), and database management skills.
Strong customer service and problem resolution abilities.
In-depth knowledge of Medicare rules and regulations, including the 72-hour rule.
Familiarity with insurance terminology, claims processing, and explanation of benefits.
Effective communication and phone skills.
Basic computer knowledge and 10-key proficiency.
Physical Requirements
Light work with occasional exertion up to 25 lbs and frequent exertion up to 10 lbs. Standing or walking may be required 11-25% of the day.
Work within a supportive environment serving a broad regional community in the Central United States, dedicated to delivering exceptional care and service.
Who can apply
Review the original listing for work authorization, qualifications and employer requirements.