Credit Analyst

Job Title: Credit Analyst - Physician Billing

Type: Direct-Hire, Full-Time

Location: Melville, NY

Compensation: $52,000+

Summary: The Credit Analyst in Physician Billing plays a pivotal role in managing and analyzing the financial aspects of physician billing operations. This position requires expertise in physician billing, proficiency in ICD-9/10 and CPT coding, familiarity with third-party billing, and comprehensive knowledge of insurance and government regulations related to payment. The Credit Analyst will be responsible for assessing credit risk, monitoring accounts receivable, and ensuring compliance with billing regulations.

Key Responsibilities:

1. Analyze physician billing records to identify trends, discrepancies, and potential credit risks.
2. Evaluate the financial health of patients and insurance companies to determine creditworthiness.
3. Review and verify coding accuracy in accordance with ICD-9/10 and CPT guidelines.
4. Manage third-party billing processes, including claim submission, follow-up, and reconciliation.
5. Stay updated on insurance and government rules regarding payment to ensure compliance.
6. Develop and implement credit procedures to mitigate risk and optimize revenue collection.
7. Assist in the claims submission and appeals process, providing support as needed.
8. Collaborate with internal departments to address billing discrepancies and resolve payment issues.
9. Monitor accounts receivable aging reports, identifying delinquent accounts and taking appropriate action.
10. Prepare reports and presentations on credit analysis findings and recommendations.

Qualifications:

• Bachelor's degree in Finance, Accounting, Healthcare Administration, or related field preferred.
• Minimum of 3 years of experience in healthcare billing, reimbursement, or collections, with a focus on physician billing.
• Proficiency in ICD-9/10 and CPT coding systems.
• Strong understanding of third-party billing processes and insurance reimbursement methods.
• Knowledge of insurance and government regulations governing healthcare payment.
• Excellent analytical and problem-solving skills, with attention to detail.
• Ability to interpret financial data and make informed credit decisions.
• Effective communication and interpersonal skills, with the ability to collaborate with internal and external stakeholders.
• Proficiency in medical billing software and Microsoft Office suite

by Jobble