Billing Analyst I

• Review and verify diagnosis codes, provider information, payer information, procedure codes and dates of service.
• Identify bills requiring research and assign bill notes and/or explanation codes indicating the reason for additional research. Apply bill/form type, modifiers and units when necessary. Process duplicate bills according to standard procedures.
• Enter bill information manually when required, calculating appropriate payment recommendation if necessary. Transfer bills that meet specific criteria; (i.e., surgical, ambulatory, etc). May consult with internal medical professionals to receive support for bill decisions to reduce legal exposure.
• Review and interpret relevant medical information including medical records, treatment reports, operative reports, consultation reports, diagnostic evaluations and functional capacity evaluations to accurately determine adjudication.
• Verify fee schedule and usual and customary rules according to state law or national guidelines. Apply advanced and/or proprietary reimbursement methodologies when appropriate.
• Communicate with providers, trainers and peers verbally and in written form.
• Meet required Quality/Production Standards while maintaining turnaround on assigned states. Ensure accurate and efficient processing; accurately report bills processed daily.
• May perform other duties as assigned.

• A high school diploma or equivalent experience is required.
• 2 or more years work experience with CPT and ICD-9 codes or classroom experience is required.
• ility to problem solve, analyze, organize and prioritize work. Strong reading comprehension, verbal and written communication skills required with Windows environment experience. Must be able to produce a high volume of quality work, be organized, multi-tasked, and prioritize work. Familiar with HFCA and UB92 forms is required.

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• Pay and incentive plans that recognize performance excellence
• Benefit programs that empower financial, physical, and mental wellness
• Training programs that promote continuous learning and career progression while enhancing job performance
• Sustainability programs that give back to the communities in which we live and work
• A culture of respect, collaboration, entrepreneurial spirit and inclusion