The Role
Enter patient demographics, insurance, and charges into the billing system accurately; identify and resolve claim rejections and account errors; reconcile and audit billing reports; post remits and payments (Square); investigate escalated billing inquiries; report trends and root causes to leadership to improve reimbursement and clean-claim rates.
Summary Generated by Built In
QUALIFICATIONS:
Education: High school diploma or GED required.
Experience:
Experience in health care billing systems preferred.
POSITION SUMMARY:
The purpose of this position is to ensure all services delivered are entered timely into the billing system and accurately submitted to insurance payers for reimbursement. This role is the first step in receiving reimbursement from payers so this candidate should possess a keen attention to detail, strong data review and analytics skills, and experience in finding root cause issues that will improve overall reimbursement from payers.
JOB DUTIES AND RESPONSIBILITIES:
Functions:
• Enter patient demographics, insurance information, and charges into the billing system for all services performed with a high level of accuracy
• Quickly identify and resolve account errors, claim rejections, and system issues that may cause reimbursement complications
• Identify trends and root causes related to inaccurate insurance billing, and report to leadership
• Collaboration across teams, contributing specialized billing knowledge to help minimize errors and increase clean claims percentages, accurate reimbursement from payers, and increase revenue
• Reconciling various billing reports and make appropriate claim corrections, identify system gaps in reporting, and audit submitted claims for potential errors
• Investigate escalated insurance billing inquiries and inaccuracies and take appropriate action to resolve the account
• Responsible for Square payments
• Breaks down remits for Medicare-Railroad Medicare, Aetna, Humana, etc.
• Completes accruals at end of month for housing
• Posts Remits
• Checks client accounts daily
PHYSICAL REQUIREMENTS:
Work is performed in an office environment. While performing the duties of this job, the employee may be regularly required to sit at desk for long periods of time. The physical demands include, but are not limited to standing, sitting, walking, lifting, carrying, reaching, handling kneeling, crouching and bending.
DISCLAIMER:
The above job description has been written to indicate the general nature and level of work performed by employees within this classification. It is not written to be inclusive of all duties, responsibilities, and qualification of employees assigned to this job.
ACCEPTANCE STATEMENT:
I have carefully read, understand, and accept the job description, including the qualifications and requirements of the position of Billing Analyst, I verify that I can and will perform the essential functions of the position. I understand Universal Precaution Risk Classification Categories may apply to this position and I may be exposed to AIDS, HIV, and Hepatitis B viruses. I further understand that this facility is of an “at will” nature, which means that I may resign at any time and be discharged at any time with or without cause.
Skills Required
- High school diploma or GED
- Experience with healthcare billing systems
- Accurate entry of patient demographics, insurance information, and charges
- Ability to identify and resolve claim rejections and account errors
- Reconcile billing reports, post remits, and complete month-end accruals
- Experience posting and managing Square payments
- Strong attention to detail, data review and analytics skills, root-cause analysis
- Ability to investigate and resolve escalated insurance billing inquiries
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The Company
What We Do
Generations/Gaither's, Inc. is a Tennessee-based provider of assisted-living and community behavioral-health services. With locations such as a McMinnville assisted-living facility, the organization operates outpatient mental-health and recovery programs addressing mental illness, substance-use disorder, trauma, homelessness, and related needs. Generations/Gaither's connects clients with local wellness resources and serves Middle Tennessee communities with a small staff-sized operation.
