Medical Records/Medical Billing Analyst

Join Midstate Radiology Associates (MRA) as a Full Time, Medical Billing Analyst at our Business Office in Wallingford.

Position Schedule: Mon - Fri, 8:00 AM - 4:30 PM or 8:30 AM - 5:00 PM

For complete listing of all open positions, visit www.midstateradiology.com/career-opportunities

Obtain medical records, fax or mail to appropriate parties. Process weekly billing. Collect monies due from insurance companies, worker’s compensation carriers, and attorneys. Manage denials by resubmitting corrected claims or appeals. Collect outstanding patient balances and provides patients with outstanding customer service.

Key Accountabilities:

1. Prints medical reports out of Epic. Fax or send medical records to Attorneys or insurance companies per their written requests. Documents patient's account in billing system.
2. Sends medical claims to insurance companies.
3. Reviews payments and explanations of benefits (EOBs) for accuracy. Facilitates secondary billing process, applying payments, adjustments, or denial notifications within billing system (Imagine).
4. Analyzes eligibility/coverage denials at carrier level and determines correct insurance information to ensure payment for the services.
5. Calls insurance carrier(s) to question denials and request re-processing of claims.
6. Utilizes insurance carrier website(s) to investigate eligibility, claim status, prior authorization, and other information needed for claim resolution.
7. Analyzes aging claims with no response, ensuring claims are on file with insurance carrier. Confirm that denials are properly recorded.
8. Follows carrier guidelines for corrected claims and appeals. Understands claim adjudication procedures, filing limits, and coding policy.
9. Identifies and reports trends relative to particular carriers, office, staff, services, providers or policies.
10. Exhibits a continual reduction in the task manager queues (tickler) that are assigned, with no unworked service greater than 60 days old.
11. Logs into the ACD line for in-coming billing inquiries from patients, practices and others.
12. Process credit card payment transactions, apply payments, or prepare notifications of declined credit cards to patient accounts. May also process HSA/HRA payments and commercial insurance credit card payments.
13. May post and balance deposits.
14. May assist with daily mail processing (retrieval, sorting, batching and distribution).
15. Maintains an active and equal call handling distribution when compared to team.
16. Contacts patients following the Fair Debt Collection Practices Act (FDCPA) guidelines to collect outstanding balances.
17. Assists patients with payment plans when appropriate.
18. Maintains strict patient confidentiality at all times. Adheres to all requirements regarding “breaking glass” in electronic health record (EHR).
19. Model H3W behaviors and maintain a positive attitude with patients and colleagues to support a pleasant and productive work environment.
20. Performs other duties as assigned.

The preceding functions have been provided as examples of the types of work performed by employees assigned to this job classification. Management reserves the right to add, modify, change or rescind the work assignments of different positions and to make reasonable accommodations so that qualified employees can perform the essential functions of the job.

Qualifications Guidelines:

Education & Experience:

• High school diploma or equivalent required.
• 1-3 years of experience with medical billing is preferred.
• Experience working with Electronic Health Records (EHR) and medical billing system preferred.

Knowledge, Skills, & Abilities:

• Customer service principles and practices.
• Ability to communicate clearly, effectively, and professionally.
• Understand and follow specifications and instructions.
• Good computer and calculator skills, including MS Office (Word, Excel, Outlook).
• Ability to research and examine carrier policy to compose appeal letters.
• Ability to set priorities, be organized, and be a self-starter.
• Knowledge of medical terminology and general coding concepts.
• Knowledge of accounts receivable practices and the FDCPA.
• Ability to maintain confidentiality of patient records.

Physical Requirements:

• Prolonged periods of sitting at a desk and working on a computer.
• Must be able to lift 15 pounds at times.
• Other physical requirements include speaking and hearing ability sufficient to communicate effectively by phone or in person at normal volumes; vision adequate to read correspondence, computer screen, forms, etc.; and good manual dexterity.

The Physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodation may be made to enable individuals with disabilities to perform the essential functions.