Medical Billing Analyst

Department/Unit:
Physicians Billing

Work Shift:

Day (United States of America)
Salary Range: $46,947.00 – $65,726.00

The Medical Billing Analyst is an intermediate billing position within the Hospital or Physicians Billing Offices for the Albany Med Health System (AMHS). This role is centered around the timely follow‑up needed on accounts that have already been billed but require re‑billing, accounts in which the payer has not responded within the regulatory guidelines, or AMHS has received a denial that needs immediate action and/or rebuttal.

The denials handled in this role are more intricate than others and often require a professional narrative accompanied by supporting documentation to be overturned. The incumbent must learn quickly, work independently, and be capable of using payer websites to locate payer policies that may impact timely payment. Communication with peers, trainers, and leaders is imperative to success.

• Resolve intricate billing edits as assigned, requiring understanding of prior claims and additional requirements for re‑billing.
• Follow up on No‑Response work queues, communicating with payers via phone, email, or website platforms.
• Locate denials or remittances via payer websites and respond to them, which may involve re‑billing updated claims or submitting appeals with supporting documentation.
• Collaborate professionally with internal or external departments, especially coding, to resolve edits or denials.
• Identify and present payer trends among claims edited for similar reasons, communicating findings to leaders to mitigate recurring issues and minimize aging accounts receivable.
• Maintain proper and detailed notation of actions taken on each account, ensuring notes are available for subsequent follow‑up.
• Navigate payer websites as needed to obtain information and understand payer policy guidelines.
• Locate claim adjudication details and supporting documentation.
• Proficiently use Epic, On Base, and other platforms required for billing.
• Work independently under time constraints and deadlines with minimal supervision, prioritizing workload effectively.
• Articulate possible avenues to resolve claim challenges and meet daily/weekly productivity and quality assurance standards.
• Perform other duties as assigned.

Identify accounts that need to be placed on payer agendas when they remain unresolved through normal dispute processes, focusing on accounts aging over 60 days. Communicate payer trends that impact overall accounts receivable, maintain timely and professional communication with outside departments, and collaborate with Patient Access and Coding. Identify department trends for management review, participate in leadership meetings, and build an understanding of expected reimbursement to ensure correct payments are received.

Access to sensitive information may be required. Workforce members must ensure that access is based on need to know and is the minimum necessary. Use or disclosure shall not exceed the minimum amount of information needed. Reasonable efforts, consistent with Albany Med Health System policies and standards, shall be made to protect information from unauthorized access and modification.

• Excellent health care coverage with no copay at Albany Medical Center providers.
• A wide array of services and programs to support emotional, physical, and mental well‑being.

Albany Med Health System is an equal opportunity employer.