Revenue Cycle Analyst - Full-time - Albany

$38,480 - $51,293/Yr

Trinity Health - Albany, NY

Full-time - Entry Level

Remote - Albany, NY

10,001+ employees

Hospitals

About the position

The Revenue Cycle Analyst position at Trinity Health is a full-time role based in Albany, NY, designed for individuals looking to contribute to the efficient operation of a medical practice. This position emphasizes a quality work-life balance, offering a strong orientation program, generous tuition allowance, and opportunities for career development. The office operates Monday through Friday, with the flexibility of one work-from-home day each week. The Revenue Cycle Analyst will be responsible for a variety of clerical duties that support the billing and revenue cycle processes, ensuring that all operations align with the mission and core values of St Peter's Health Partners Medical Associates. In this role, the analyst will monitor and resolve claims work queues, focusing on front-end processes, referrals, authorizations, and clinical workflows. They will also review denial and rejection trends, providing necessary education to providers and front-end users to enhance operational efficiency. The analyst will ensure that all necessary referral documentation is obtained to secure appropriate revenue and will run monthly reports to identify outbound referrals, communicating improvement opportunities to management. The position requires the analyst to ensure that all billable services are processed in the Electronic Medical Record (EMR) system in a timely manner and that all claims submitted to insurance are clean and accurate. The analyst will work within the claims scrubber to review charges, identify problematic charges, and adhere to productivity and quality guidelines. Effective communication with other departments is essential, as is the ability to provide feedback to the Revenue Integrity team and assist in training and support for site operations. The role also includes responsibilities for charge reconciliation, reporting outstanding claims, and maintaining patient confidentiality in accordance with HIPAA regulations.

Responsibilities

• Monitor and resolve Claims Work queues, including Front End, Referrals & Authorizations, and Clinical Workflow.
• Review 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.
• Run monthly reports to identify outbound referrals and communicate improvement opportunities to Manager.
• Ensure all billable services are processed within the EMR in a timely manner.
• Submit all billed services to insurances as 'Clean Claims'.
• Review all charges and submit to claims scrubber.
• Work all claims scrubber edits in a timely manner.
• Identify 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.
• Provide necessary feedback from operational departments to Revenue Integrity team as appropriate.
• Act as a Superuser for the site and act as a resource for patient questions.
• Maintain patient confidentiality and adhere to HIPAA regulations.
• Perform mandatory in-service training and maintain a clean and safe work environment.
• Adhere to the St Peter's Health Partner's Medical Associates Code of Conduct in performance of all job duties.
• Report out to managers weekly on revenue data and updates.
• Attend mandatory meetings.

Requirements

• High school diploma or equivalency required; Associates degree preferred.
• Effective written and verbal communication skills.
• 3+ years' experience in a physician practice or billing office.
• 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.

Benefits

• Strong orientation program
• Generous tuition allowance
• Career development opportunities
• Work from home flexibility (1 day a week)