Billing Operations Specialist
1 month ago
We are seeking a highly skilled Billing Coordinator to join our team at Mount Sinai Health System. As a key member of our revenue cycle team, you will play a critical role in ensuring the efficient and timely resolution of unpaid and partially paid claims.
Responsibilities- Follow up on submitted claims and monitor unpaid claims to ensure timely resolution.
- Work with payers and providers to resolve EOB discrepancies and negotiate higher claim payments.
- Ensure that established billing targets for collections, gross, days in A/R, and net collection ratios are met.
- Analyze claims system reports to identify underpayments and work with payers to collect owed amounts.
- Respond to patient and third-party inquiries, research and resolve complex claims, and correct errors.
- Review correspondence and rejection data from insurance carriers, post rejections, and perform reconciliations.
- Transfer secondary balances to appropriate financial classes and provide documentation for processing claims.
- Review, work, and clear electronic and claims edits daily, summarizing and forwarding non-workable edits to supervisors for resolution.
- Process refunds for supervisory approval.
- Mentor less experienced staff and assist the Billing Manager with the training of new hires.
- Associates degree or HS diploma/GED plus two years of related experience.
- 3 years of healthcare billing experience required.
- Familiarity with CPT and ICD coding and CCI edits.
- Electronic claims processing preferred.
Mt. Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 43,000 employees working across eight hospitals, over 400 outpatient practices, and more than 300 labs. We are committed to delivering exceptional patient care and advancing health for all people, everywhere.
We are an equal opportunity employer and do not discriminate on the basis of race, color, national origin, age, religion, disability, sex, sexual orientation, gender identity, or gender expression. We are passionately committed to addressing racism and its effects on our faculty, staff, students, trainees, patients, visitors, and the communities we serve.
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