Revenue Cycle Management Billing Analyst

We are looking for an experienced Revenue Cycle/Medical Billing professional with strong remittance advice experience to join and exciting and growing biotech client of ours. Remittance advice experience is required.

• 100% on site
• 9 month contract to potential hire
• Pay: $24-$26hr

Summary:

The Revenue Cycle Management Billing Analyst is responsible for contributing to revenue cycle, healthcare insurance, and financial reporting and support of daily RCM/ insurance billing activities of our commercial clinical CLIA lab which provides physician-ordered clinical/ molecular pathology and next-generation sequencing testing services for patients with solid tumors and hematologic malignancies.

Responsibilities:

• Sending and receiving payments from the commercial lab.
• Working heavily with Finance logs.
• Fielding outbound and inbound calls from payors and patients.
• Billing. Coordinate insurance benefits & eligibility checks, pre-authorization (PA), network gap exceptions, claim submissions, denial appeal processes, patient and provider invoicing, and collections.
• Organization. Ensure the completeness and accuracy of all patient records and organized appropriately within the EMR system.
• Compliance. Ensure strict adherence to all governmental and corporate regulatory requirements relative to insurance and patient billing, and assist with internal and external audits as necessary.
• Customer Communication. Communicate with providers and patients to collect additional information to support insurance billing processes as necessary, as well as respond to billing inquiries from these customers. Resolve daily emails related to test orders and billing processes.
• Payor Communication. Follow up with payors as necessary on pre-authorization, gap exceptions, claims, billing inquiries, single case agreements, credentialing/ contracting, etc. Obtain and process correspondence including medical records requests, remittance advice/ EOBs, and denials from various payors/ payor portals and bank lockbox, as well as RCM systems.
• Payments. Record and reconcile bank lockbox, RCM/billing system, and EMR system data, etc. to ensure all deposits and refunds are accurately accounted for within AR and AP logs.
• Collections. Reconcile AR to ensure open AR is properly cleared through the system's interface.
• System Reconciliation. Reconcile systems data (LIMS, RCM, and clearinghouse) daily to ensure data integrity/ accuracy, and that all transactions are correctly posted and accounted for across all data sources.
• Financial Closing. Assist in financial period closing requirements (e.g., month-end, quarterly, annual)

Requirements & Competencies:

• Requires a minimum of 1-2 years direct experience in healthcare insurance AR, billing operations and reimbursement, or provider account management with a focus on post billing activities.
• Experience should include benefits investigation, pre-authorization, claim submission, denial appeals, interpreting remittance advice, EOBs, navigating EMR and RCM/ billing systems, and communicating with patients, providers, payors, and vendors.
• Experience in HIPAA-regulated work environments is required.
• Experience working with health insurance remittance advice is required.
• Experience should span commercial, and Medicare, Medicaid, and other government health plans/ payors.
• Working familiarity with CPT and ICD-10 coding.