Revenue Integrity Analyst (Medical Biller)

This position is responsible for many areas of the revenue cycle beginning with the submission of a clean claim. The analyst will monitor the life cycle of the claim including follow up, denial management, and correspondence to the payers including appeals process.  Reconciliation of accounts will be required along with completion of refunds to patients or payers as deemed appropriate.  The revenue integrity analyst will be required to work with Patient Access, Patient Financial Services team members, Medical Records, and Utilization Review as needed to secure reimbursement for claims.

Responsibilities:

• Maintains a systematic and fully integrated insurance billing and follow up as established by hospital policies and procedures.
• Reviews accounts for accuracy of charges prior to billing insurance, identifies sources of error, informs the supervisor, and initiates constructive suggestions to correct the error.
• Maintains accurate on-line documentation on all insurance filing and patient contact related to concerns, questions, and/or issues on accounts.
• Answers and initiates telephone inquiries to/from patients and third-party payers as needed; documents activity in account (s).
• Completes reconciliation of accounts along with completion of refunds to patient and payers as needed.
• Works with all necessary departments as needed to secure reimbursement for claims.
• Coordinates with manager for charge additions and corrections.
• Able to plan work detail and meet schedules consistently and promptly.
• Demonstrates responsibility for use of equipment, software and supplies used in job process.
• Identifies problems and offers constructive suggestions for improvement within department.
• Identifies problem accounts with payers; investigates and corrects errors, follows-up on missing account information, and resolves past-due accounts. May contact attorney’s, employers, physicians, and others necessary to obtain information for resolution of credit and collection matters.
• Manages monthly school billing accounts.
• Patient financial counseling through resources with PARO, financial assistance program and Care payment partners. Processing of patient payments.
• Responsible for handling reports to and from third party vendors.
• Adheres to HIPAA policies; maintains patient and facility confidentiality.
• Maintains knowledge of hospital policies as they pertain to billing operations.
• Attends in-services, seminars, educational meetings as applicable.
• Participates in informal teaching of new employees/co-workers.
• Possesses the ability to work under stressful conditions and remain helpful, courteous, and still perform job functions accurately and timely.
• Performs other duties and responsibilities as assigned.

Position Requirements:

• 3 years of experience in a medical billing role required; Hospital experience preferred.