Billing Analyst

Summary of Job Duties

:The role of a Billing Analyst is integral to ensuring accurate and efficient billing processes within an organization. This position requires a keen eye for detail, strong analytical skills, and proficiency in financial systems and software. The Billing Analyst plays a crucial role in managing billing activities, resolving discrepancies, and optimizing revenue generation.

Qualifications:

Minimum Qualifications:

Bachelor’s degree in business or related field with 1 year of experience OR High School diploma plus 5 years equivalent combination of education and experience in medical billing.

Additional Information:

Additional Information:

• Assess the adequacy of health record documentation to ensure that it supports all diagnoses and procedures to which codes are assigned;
• Apply knowledge of anatomy and physiology, clinical disease processes, and pathology diagnostic and procedural terminology to assign accurate codes to diagnoses and procedures;
• Reviews charges to ensure accurate CPT and ICD-10 coding. 
• Requests corrections/modifier additions/changes from Certified Professional Coder or Coding Manager.
• Reviews notes and communicates with physicians as needed for documentation questions.
• Has current knowledge of third-party requirements for reimbursement, particularly for Arkansas Medicaid.
• Ensures that Medicaid specific modifiers (non-reimbursement effecting) are present for HSEs (EPSDT). The specific modifier informs Medicaid if the visit generated a new referral for a service, or is under current treatment, or no new referral, or patient refused referral.
• Enters modifiers for no referral, filing deadline, etc. when working follow up work queue. Medicaid specific modifiers required for foster care exams done in GPC.
• Processes professional billing.
• Processes billing and customer service requests for outreach clinics.
• Works F/U work queues in Epic for claim denials and requested corrections.
• Manually posts charges as needed.

Salary Information:

Commensurate with education and experience

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