Revenue Cycle Analyst - Full-time - Troy

$38,480 - $51,293/Yr

Unclassified - Troy, NY

Full-time - Entry Level

Remote - Troy, NY

10,001+ employees

About the position

The Revenue Cycle Analyst position at St. Peter's Health Partners Medical Associates is a full-time role that focuses on the efficient and service-oriented operation of a medical practice. The Billing Analyst will be responsible for a variety of clerical duties that are essential to the revenue cycle process. This position emphasizes quality of life, offering a strong orientation program, generous tuition allowance, and opportunities for career development. The office hours are Monday through Friday, with the flexibility of one work-from-home day per week after a 90-day probation period. 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 be responsible for reviewing denial and rejection trends, ensuring that all necessary referral documentation is obtained, and running monthly reports to identify outbound referrals. The position requires effective communication with other departments and collaboration with the Revenue Cycle Manager to identify feedback and improvement opportunities. The Billing Analyst will ensure that all billable services are processed in a timely manner, submitted as clean claims, and will work within the working queue to review charges and submit them to the claims scrubber. The role also involves identifying problematic charges, adhering to productivity and quality guidelines, and maintaining patient confidentiality in accordance with HIPAA regulations. The analyst will report weekly on revenue data and updates, attend mandatory meetings, and perform other duties as assigned.

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.
• 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 ensure all claims are billed timely.
• Review each claim for appropriate information and identify high dollar outstanding balances.
• 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 and 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, 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 after 90 days probation