The MSO Billing Analyst is responsible for overseeing the payer reimbursement and follow up activities for all insurance and patient revenue for the MSO which provides services to Y- USA stakeholders and local Ys delivering chronic disease prevention programs designed to reduce health risks in the context of established chronic diseases (e.g., diabetes, arthritis, cancer). The incumbent will be responsible for all back end billing activities and processes, the implementation of policies and procedures, management of back-end billing and claims resubmission procedures and third-party insurance carriers.
- Associates degree or equivalent experience required in healthcare/physician revenue cycle
- Must have full understanding of insurance follow-up processes (i.e. Billing, Collections, Managed Care, Medicare, Medicaid Commercial Practices and Corporate BillingModels)
- Five (5) or more years physician/medical billing experience, specifically with denials, payment posting and resolving complex third party payor reimbursement issues.
- Working knowledge of CPT, HCPCs and ICD-10 coding required; Medical billing or coding certificate preferred
- Five (5) or more years of EMR/EHR experience required
- Demonstrated skill with problem-solving skills and the ability to think critically
- Ability to learn/ stay abreast of relevant policies
- Excellent PC skills including MS Office applications (Word, Excel,PowerPoint) required
- Detail oriented, well organized and able to work independently
- Outstanding listening skills
- Demonstrated ability to perform under pressure in a calm manner
Areas of Responsibility:
- Manages financial activity and insurance activities within the billing system.
- Processes account adjustments when applicable, including reviewing and resolving edits created by internal billing system and electronic transfer.
- Coordinate with claims department to prepare and generate corrected invoice, paper claims and billing statements.
- Coordinates with Finance Department in monitoring and processing unpostables, unapplied credits and overpayments within the system in a timely manner.
- Ensures pertinent information relating to patient accounts and/or payer interactionis documented in billing system.
- Managesmonthlyaccountsreceivableactivityandreportingtoseniormanagement.
- Communicates effectively, both verbally and in writing, tot hird party payors, government agencies, MSO staff and other internal departments
- Other duties asassigned
Educational Background:
Associates degree or equivalent experience required in healthcare/physician revenue cycle
Skills/Experience:
- Must have full understanding of insurance follow-up processes (i.e. Billing, Collections, Managed Care, Medicare, Medicaid Commercial Practices and Corporate BillingModels)
- Five (5) or more years physician/medical billing experience, specifically with denials, payment posting and resolving complex third party payor reimbursement issues.
- Working knowledge of CPT, HCPCs and ICD-10 coding required; Medical billing or coding certificate preferred
- Five (5) or more years of EMR/EHR experience required
- Demonstrated skill with problem-solving skills and the ability to think critically
- Ability to learn/ stay abreast of relevant policies
- Excellent PC skills including MS Office applications (Word, Excel,PowerPoint) required
- Detail oriented, well organized and able to work independently
- Outstanding listening skills
- Demonstrated ability to perform under pressure in a calm manner
Compensation/Benefits:
Salary: $60,000.00 - $62,000.00
Job Function:
Organization Info
Listing Stats
Post Date:
Mar 15 2018
Active Until:
Apr 15 2018
Hiring Organization:
YMCA of the USA
industry:
Nonprofit