Billing Analyst

Community Health System Nashville , TN 37201

Posted 2 days ago

Summary:

The
Billing Analyst reports directly to the Sr. PCCM Director. The Billing Analyst
is responsible for billing paper and electronic claims for primary and
secondary payers as requested by the Payment Compliance team. The Billing Analyst will complete timely and
accurate billing for designated payers ensuring all claims are submitted within
three days of the request from the PCCM team; monitor outstanding accounts; and
will answer billing-related inquires. The Billing Analyst should be
knowledgeable with state and federal regulatory agencies and payer information
to maintain up-to-date knowledge on changing rules and regulations affecting payment
compliance and contract management as well as the general revenue cycle.

Essential Duties and Responsibilities:

Bill all primary and secondary insurance claims
in a timely and accurate manner via the electronic billing system
Demonstrate a working knowledge of all appropriate
billing forms including UB04, 1500 or state specified forms
Understand edits, the relationship between host
AR system and clearing house, and billing related reports
Demonstrate working knowledge of federal, state,
local and intermediary specific billing requirements to ensure appropriate
authorizations are completed and/or notifies appropriate person of missing
or incomplete billing requirements and follows up in a timely manner
Maintain currency in regards to methods of
billing, laws and CHS policies relating to insurance claims and electronic
submission claims
Submit re-billed claims for approval and tracking
the approval process of claims
Audit each bill for charges, duplications and
overlapped accounts before billing making any necessary adjustments and
documenting appropriately
Maintain and secure medical documentation to
support claims or appeals as necessary
Resolve claim errors on the billing system in a
timely manner by reviewing claim error reports and taking appropriate
action
Document billing activity including, but not
limited to bill dates, notes, and
electronic note posting
Ensure system balancing
Identify additional billing edits required to
submit clean and compliant billing to various payers
Ensure accurate and complete clean claim
submission for both paper and electronic claims in a timely manner
Maintain productivity per established standards
by maintaining accurate and complete productivity reports
Perform other required duties in a timely, professional,
and accurate manner
Cooperate with others to meet department
requirements and goals
Identification, documentation and recommendations
of PCCM electronic billing (Click On/ SSI) issues
Other duties assigned by the PCCM Director

Qualifications:

A minimum of one year
healthcare billing experience and/or equivalent education or job related
activities is required. Knowledge of
insurance claims and billing is required. This position requires a highly
organized individual with the initiative to work independently. He/she must be
proficient with telephone and email communications and have the ability to
prioritize work to meet deadlines as required.
Knowledge of federal, state and local insurance billing regulations and
guidance is required.

Reasoning Ability: Ability to define problems, collect data, validate
data, establish facts, and draw valid conclusions.

Computer Skills:
To perform this job successfully, an individual should
have knowledge of hospital patient accounting systems and billing systems, MS
Excel, MS Office Systems, Access, SSI, DDE, MED Host, Cerner, McKesson and,
Medi Tech.

Certificates and
Licenses: None
required

Education/Experience/Skills:

Associate or B.S Degree
preferred, but not required. Must be a high school graduate.
Medical and Medicare billing
experience required
Strong analytical
skills and strong proficiency in Microsoft Office Tools
Minimum one year
experience with hospital billing and/or collections
Knowledge of HMS, Meditech
Systems, and SSI Electronic Billing System preferred


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