Medical Billing Associate - Albany Medical Center

Department/Unit: Patient Billing Service Work Shift: Day (United States of America) Salary Range: $46,215.00 - $60,080.00 Overview The Medical Billing Associate is a position located within the Hospital or Physician Billing Offices. The role is centered around the timely and efficient billing and follow up of medical claims throughout the Albany Med Health System (AMHS). This role focuses on pre‑billing edits as well as some introductory payer denials. Claims must meet regulatory requirements as well as specific payer policies. The edits are in place to ensure that clean claims are sent to the payers. Introduction to denial resolution is also part of this role. Initiating an appeal or rebilling the claim to address the denial is paramount to receiving payment. The incumbent will be expected to work independently and meet production standards after the prescribed onboarding and training is concluded. Communication with peers, trainers, and leaders will also be imperative to success. Essential Functions Resolve all billing edits found in the assigned WQs. Respond to denials received on accounts as assigned, re‑billing claims after updating correct information or initiating disputes or appeals to the payer. Collaborate professionally internally or with external departments when needed to resolve edits or denials. Recognize payer trends among the claims edited for similar reasons and communicate these trends to leaders to determine if a systematic update is required. Identify payer trends within denials and work with leaders to mitigate those denials where possible, with the goal of minimizing aging accounts receivable. Maintain proper and detailed notation of actions taken on the account for future follow up. Navigate payer websites as needed to obtain information. Review, understand, and locate payer policy guidelines for billing or denial resolution. Proficient use of Epic, On Base, and other platforms as needed. Work independently and under time constraints and deadlines with minimal supervision, prioritizing workload effectively. Meet daily/weekly productivity standards with acceptable QA results. Other duties as assigned. The role may require access to sensitive information, including but not limited to HIPAA Protected Health Information, and confidentiality must be maintained in accordance with federal and New York State statutes. Qualifications High School Diploma EEO Statement Albany Med Health System is an equal opportunity employer. #J-18808-Ljbffr