Job description
Overview
The Billing Analyst is responsible to analyze, monitor and control billing processes through key indicator and data control reports to ensure the integrity of billing data. Applications utilized are: Word, Excel, Crystal, OBR, GPMS, RDS, BabySteps, SounData, Onbase, E-Mail, the Internet, Master Database, and Imaging.
Responsibilities
Analyze the cause of all billing errors.
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Daily review Claims Manager, OBR and GPMS edit reports.
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Review errors with associates and re-train as necessary. Monitor errors until resolved.
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Identify opportunity for new edits based on billing analysis.
Complete daily Tie Out process of all interfaces.
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Validate daily import of RDS/BS interface.
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Balance Hash Totals and identify any skipped and/or duplicated batches.
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Identify and report to IS any system issues.
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Work with IS to achieve timely resolution of all daily issues.
Validate weekly uploads from SounData interface.
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Review Exception report to identify any outstanding data.
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Identify and report any system issues to IS.
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Work with IS to achieve timely resolution of all daily issues.
Monitor daily EPM Exception report and work with Practice to resolve any open issues.
Validate daily ximport of data from OBR to GPMS.
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Balance Hash Totals and identify any failed transactions.
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Identify and report any system issues to IS. Work with IS to achieve timely resolution of all outstanding daily issues.
Complete daily edit reports for OnBase scanning. QC scanned batches for validation of completeness.
Continuously monitor and audit the billing control processes and operations.
Perform coding clean-up when required.
Participate in weekly Claims Manager meetings.
Participate in Regional meetings for edit evaluation, as required.
Perform end of month process.
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Validate month end ximport process. Report validation to IS.
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Execute Auto Write-Off program for all practices.
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Generate AR status report for each region. Report completion to IS.
Work special projects at the Billing Operations Manager discretion.
Perform testing for all system upgrades. Validate upgrades in production once implemented.
Maintain strict confidentiality in accordance with HIPAA regulations and Company policy.
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Any patient private health information (PHI) must not be divulged on any account except to payers that need the information in order to process the claim for payment.
Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.
Performs other job-related duties within the job scope as requested by Management of Patient Accounts.
Embodies the principles of the corporate Mission Statement and Philosophy at all times.
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Represents the corporation in a positive fashion and makes all individuals feel as comfortable as possible.
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Conducts all business in a professional manner maintaining respect for individuals at all times.
Complies with departmental and company-wide policies and procedures.
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Maintains constant awareness of potential safety hazards insuring necessary safety precautions.
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Reads and complies with established policies and procedures.
Qualifications
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Associate's degree (A. A.) or equivalent from two-year college or technical school; or one to two years related experience and/or training; or equivalent combination of education and experience.
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Ability to add, subtract, multiply, and divide in all units of measure, using whole numbers, common fractions, and decimals. Ability to calculate figures and amounts such as discounts and percentages.
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Ability to interpret a variety of instructions furnished in written, oral, diagram, or schedule form. Ability to define problems, collect data, establish facts, and draw valid conclusions.
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