Medical Billing Specialist

Role Overview

• Resolve all levels of denials.
• Professional appeal submission with supporting documentation.
• Identify and present the payer trends amongst the claims that are denying.
• Communicate and work with the leaders to mitigate.
• Collaborate professionally internally or with external departments when needed to resolve the edit or denial.
• Present appropriate accounts for payer agendas with clear rationale and supporting documentation.
• Ability to be the learning partner for peers.
• Manage and complete assigned projects timely.
• Proper and detailed notation of actions taken on the account.
• Review, understand, and locate payer policy guidelines as required.
• Ability to locate claim adjudication details with the supporting documentation.
• Proficient use of Epic, OnBase, and other platforms as needed.
• Meet daily/weekly productivity standards with acceptable QA results.

Requirements

• High School Diploma/G.E.D.
• required
• Associate's Degree
• preferred
• 2+ years medical billing experience
• required
• Strong Epic Resolute billing experience
• required
• Ability to work independently and within a team
• Excellent verbal and written communication skills.
• Ability to communicate with internal peers and leadership
• Demonstrates an ability to learn and understand instruction
• Ability to effectively prioritize and execute tasks in a high-volume atmosphere.
• Microsoft Office and website knowledge
• CCS-Certified Coding Specialist
• Certified Inpatient Coder (CIC) or Certified Outpatient Coder (COC) Upon Hire
• preferred
• Equivalent combination of relevant education and experience may be substituted as appropriate.

Benefits

• 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 wellbeing