The Medical Billing Analyst collects monies due from insurance companies, worker’s compensation carriers, and attorneys. Manages denials by resubmitting corrected claims or appeals. Collects outstanding patient balances and provides patients with outstanding customer service.

• Review payments and explanations of benefits (EOBs) for accuracy. Facilitates secondary billing process, applying payments, adjustments, or denial notifications within billing system (Imagine).
• Analyzes eligibility/coverage denials at carrier level and determines correct insurance information to ensure payment for the services.
• Calls insurance carrier(s) to question denials and request re-processing of claims.
• Utilizes insurance carrier website(s) to investigate eligibility, claim status, prior authorization, and other information needed for claim resolution.
• Analyzes aging claims with no response, ensuring claims are on file with insurance carrier. Confirm that denials are properly recorded.
• Follows carrier guidelines for corrected claims and appeals. Understands claim adjudication procedures, filing limits, and coding policy.
• Identifies and reports trends relative to particular carriers, office, staff, services, providers or policies.
• Exhibits a continual reduction in the task manager queues that are assigned.
• Logs into the ACD line for in-coming billing inquiries from patients, practices and others.
• 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.
• May post and balance deposits.
• May assist with daily mail processing (retrieval, sorting, batching and distribution).
• Maintains an active and equal call handling distribution when compared to team.
• Contacts patients following the Fair Debt Collection Practices Act (FDCPA) guidelines to collect outstanding balances.
• Assists patients with payment plans when appropriate.
• Maintains strict patient confidentiality at all times. Adheres to all requirements regarding “breaking glass” in electronic health record (EHR).

Desired Qualifications:

• High School Diploma or Equivalent
• 1+ years of experience with medical billing preferred
• Knowledge of medical terminology and general coding concepts.
• Knowledge of accounts receivable practices and the FDCPA.
• Ability to maintain confidentiality of patient records.
• Excellent communication and interpersonal skills are required.
• Good computer and calculator skills, including working knowledge of MS Office (Word, Excel, Outlook).
• Ability to work with medical billing software and Electronic Health Records
• Bilingual is a plus - English and Spanish