RCM Billing Analyst

The Billing Analyst is responsible for analyzing, researching, and resolving issues related to the creation and submission of paper and electronic claims. Works with the Business Systems Department to create effective clearinghouse edits that respond to errors generated from electronic claims submissions. Monitors claim errors until resolved and identifies opportunities for new edits based on billing analysis.

Additional responsibilities include daily review of Claims Manager, OBR, and GPMS edit reports; reviewing errors with associates and retraining as necessary; monitoring errors until resolved; validating daily imports from the RDS/BS interface; balancing hash totals and identifying skipped or duplicated batches; reporting system issues to IS and working with IS to achieve timely resolution; validating weekly uploads from the SounData interface; monitoring the daily EPM Exception report and working with the practice to resolve open issues; completing daily edit reports for OnBase scanning; quality-checking scanned batches for completeness; continuously monitoring and auditing billing control processes and operations; performing coding clean-up when required; completing end-of-month processes; and testing system upgrades and validating production implementations.

The role requires maintaining strict confidentiality in accordance with HIPAA regulations and company policy, while presenting a positive and professional demeanor in the performance of assigned duties.