Revenue Cycle/Medical Billing - Urology - Clifton Park

Revenue Cycle Analyst – Urology Team – Clifton Park, NY - FT

This position is located at 855 Route 146, Clifton Park, NY. If you are looking for a Medical Billing / Revenue Cycle position in the Capital Region, Full time, this could be your opportunity. Here at St. Peter's Health Partner's, we care for more people in more places. This Revenue Cycle Analyst is needed for the medical group. Coding and EPIC knowledge not required but a plus. Must have knowledge of health insurance. Seeking a motivated and enthusiastic candidate to join our urology specialty team. This revenue cycle analyst role is ideal for someone with a strong medical office background who enjoys collaborating across teams and presenting information with confidence. Primary Location: Clifton Park Additional sites: Troy and Albany Travel to other sites required once a month.

Key Responsibilities: Support urology practice operations across multiple sites Utilize insurance knowledge to assist office workflows Analyze and interpret reports and data Communicate clearly and confidently, including speaking in front of groups.

Responsibilities:

• Responsible to monitor and resolve Claims Work queues, Specifically Front End, Referrals & Authorizations, and Clinical Workflow.
• Responsible for monitoring the Trinity Health Front End Metrics and working with Practice Management to identify educational opportunities as necessary.
• Responsible for review of denial/ rejections and write off dashboards for trends and provide necessary education to Providers/ front end users.
• Ensure all necessary referral documentation is obtained and documented to secure appropriate revenue.
• Responsible for running monthly reports to identify any outbound referrals and communicate back to Manager for any improvement opportunities
• Ensures all billable services are processed within the EMR in a timely manner.
• Ensures all billed services are submitted to insurances as "Clean Claims"
• Works within the working queue to review all charges and submit to claims scrubber
• Work all claims scrubber edits in a timely basis
• Identify any problematic charges for further review to correct coding/billing issues
• Adhere to productivity/quality guidelines
• Communicate effectively and professionally with other departments within the organization
• Work with Revenue Cycle Manager to identify needed feedback to practice locations.
• Process inpatient charges submitted by providers via interface tool or manual sheets
• Manually enter charges as assigned and complete charge reconciliation daily.
• Report any outstanding claims to contact to ensure all claims are billed timely
• Review each claim for appropriate information.
• Identify and review high dollar outstanding balances and ensure Financial Assistance options are offered to patients and/ or secured by Front End users.
• Provide necessary feedback from operational departments to Revenue Integrity team as appropriate
• Act as a Superuser for the site and act as a resource, to ensure patient questions are answered.
• Maintain patient confidentiality and adhere to HIPAA regulations as appropriate.

• Daily TOS reconciliation with front end

Qualifications: Medical office experience required Strong understanding of insurance processes Report analytics skills Medical coding experience preferred but not required self-motivated, enthusiastic, and professional demeanor Excellent communication and presentation skills

What you will need:

• High school diploma or equivalency required; Associates degree preferred.
• Effective written and verbal communication skills
• 3+ years' experience in a physician practice or billing office
• Demonstrated attention to detail, organization & effective time management
• Ability to work independently with little supervision
• Knowledge of CPC
• Knowledge of CPT, CPTII, and ICD10
• Knowledge of insurance carriers
• Solid judgment to escalate issues appropriately
• Advanced knowledge of Microsoft Office, related computer programs & general office machines
• Ability to lift 20 lbs.

Pay Range : $20.20 - $27.47

Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.

Our Commitment

Rooted in our Mission and Core Values, we honor the dignity of every person and recognize the unique perspectives, experiences, and talents each colleague brings. By finding common ground and embracing our differences, we grow stronger together and deliver more compassionate, person-centered care. We are an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, or any other status protected by federal, state, or local law.