Revenue Cycle Analyst - Full-time - Hybrid

$38,480 - $51,293/Yr

Unclassified - Albany, NY

Full-time - Entry Level

Remote - Albany, NY

10,001+ employees

About the position

The Revenue Cycle Analyst position at St. Peter's Health Partners is a full-time role that offers a hybrid work environment, allowing for one work-from-home day each week. This position is integral to the efficient and service-oriented operation of a medical practice, focusing on billing and claims management. The Billing Analyst will be responsible for a variety of clerical duties that ensure the smooth functioning of the revenue cycle, adhering to the mission and core values of the organization. The role emphasizes quality of life, with a strong orientation program, generous tuition allowance, and opportunities for career advancement. The office hours are Monday to Friday, with an 8-hour shift scheduled flexibly between 7:30 AM and 5 PM. In this role, the Billing Analyst will monitor and resolve claims work queues, specifically focusing on Front End, Referrals & Authorizations, and Clinical Workflow. The analyst will also review denial and rejection trends, ensuring that all necessary referral documentation is obtained to secure appropriate revenue. Monthly reports will be generated to identify outbound referrals, and the analyst will work closely with the Revenue Cycle Manager to provide feedback and identify improvement opportunities. The position requires effective communication with other departments and adherence to productivity and quality guidelines, ensuring that all billable services are processed in a timely manner and submitted as clean claims to insurance providers. The analyst will also act as a superuser for the site, providing resources and support to ensure patient questions are answered and maintaining patient confidentiality in compliance with HIPAA regulations.

Responsibilities

• Monitor and resolve Claims Work queues, specifically 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 back to Manager for improvement opportunities.
• 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, working all claims scrubber edits in a timely manner.
• Identify problematic charges for further review to correct coding/billing issues.
• Adhere to productivity/quality guidelines and communicate effectively with other departments.
• Process inpatient charges submitted by providers via interface tool or manual sheets and complete charge reconciliation daily.
• Report any outstanding claims to ensure all claims are billed timely.
• 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 a clean and safe work environment and adhere to the Code of Conduct.

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, CPT, CPTII, and ICD10.
• Knowledge of insurance carriers.
• Solid judgment to escalate issues appropriately.
• Advanced knowledge of Microsoft Office and related computer programs.
• Ability to lift 20 lbs.

Benefits

• Generous tuition allowance
• Career development opportunities
• Flexible schedule with one work-from-home day per week