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Billing Analyst

Springfield ClinicSpringfield🇺🇸United States

Quick overview

SeniorityMid Senior
Employment typeFull Time
Work modeHybrid
LocationSpringfield, United States
Compliance

Job description

The Billing analyst is responsible for monitoring and analyzing the accuracy and integrity of the various aspects of the billing/reimbursement process.  Responsible for analyzing billing laws and contract regulations to ensure the most efficient billing of third-party payers by Springfield Clinic, and completing projects involving analysis of denials, billing errors, and reimbursement questions.
Job Relationships
Reports to the Billing Compliance Manager
Principal Responsibilities
Note: Following duties will be assigned at the direction of the Billing Compliance Manager; because of multiple staff at position all of the following duties may not be assigned to a specific staff member per the work plan of the Billing Compliance Unit.
  • Work on research projects as assigned towards proper reimbursement by third-party payers.
  • Analyze Medicare and Medicaid regulations and assist in education efforts for providers and staff towards compliance with these rules.
  • Analyze contractual insurance plans towards assurance that Springfield Clinic receives reimbursement as defined in various contracts and fee schedules.
  • Work on projects as assigned towards overall billing compliance with all laws and regulations. Perform Compliance Audit Reports as assigned with follow-up reporting to Patient Accounting Coding and Billing Oversight Committee and/or Springfield Clinic Compliance Committee.
  • Provider education projects and responsibilities as assigned. Could involve face-to-face meetings, educational memos, participation in orientation sessions, etc.
  • Assist in maintaining pre-submission claim editing systems and analysis projects resulting from reports of that system as assigned.
  • Analyze monthly insurance denial reports as assigned.
  • Serve as occasional backup, as needed, to other Billing Compliance Unit staff members
  • Comply with the Springfield Clinic incident reporting policy and procedures.
  • Adhere to all OSHA and Springfield Clinic training & accomplishments as required per policy.
  • Provide excellent customer service and adhere to SC Way customer service philosophy.
  • Other duties as assigned.
Education/Experience
  • High School graduate or GED required; college preferred.
  • Minimum three (3) years of insurance billing/review work required.
Knowledge, Skills and Abilities
  • Strong analytical and communication skills.
  • Proficiency using software applications to perform job duties.
  • Ability to work independently on assigned duties with minimal supervision.
  • Ability to further knowledge of laws and regulations by continuing education efforts (reading manuals/subscriptions/newsletters; attending in-services and educational conferences).
  • Manual dexterity required for use of calculator and computer keyboard.
Working Environment
  • Working in high stress area that may involve handling angry customers.
  • Some amount of travel, typically locally required.
  • Requires sitting and standing for periods of time working in an office environment.
PHI/Privacy Level
HIPAA1

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