Billing Analyst I

Description

Job Summary:

The Billing Analyst I is responsible for managing and ensuring accuracy in the billing process for insurance payors and durable medical equipment (DME) claims. This role requires a strong understanding of healthcare revenue cycle management specific to DME to effectively identify and resolve billing discrepancies. The Billing Analyst I will work closely with cross-functional teams, including Finance and Billing, to optimize the billing cycle and ensure accurate revenue capture. Additionally, this role will assist in maintaining and updating work instructions (WIs) and standard operating procedures (SOPs) to uphold consistency and compliance in DME billing practices.

Key Responsibilities:

Billing Operations:

• Maintain and update billing records, including contracts, rates, and account details in the billing systems.
• Assist in validating payor fee schedules and identify price tables that need updates, ensuring changes are reflected in the system and tracked on the price table tracking sheet.
• Conduct research and complete templates for payor add requests to ensure accuracy in the billing system.
• Understand and help communicate the impacts of system enhancements to the relevant teams.

Analysis & Reporting:

• Analyze billing data to identify trends, discrepancies, and opportunities for improving billing accuracy and efficiency.
• Assist in generating regular reports for management on billing performance, including billing volume, aging invoices, and collection rates.
• Contribute to revenue forecasting by analyzing billing patterns and historical data.
• Perform other duties as assigned by the manager.

Process Improvement:

• Assist in identifying and implementing improvements to billing processes and systems to enhance accuracy and efficiency.
• Collaborate with teams to resolve system-related issues and improve the billing workflow.
• Help develop and maintain billing process documentation, ensuring compliance with company standards and regulatory requirements.
• Support system upgrades or implementations that affect billing functions, including participating in testing and providing user training.

Department Support:

• Process requests for user access to payor portals and updates/changes to the Payor Resource Matrix (PRM).
• Ensure requests are completed within 24 hours of receipt in accordance with department SLAs.
• Assist teams with updating work instructions (WI) and standard operating procedures (SOPs).

Key Qualifications:

• 2-4 years of experience in a billing, accounts receivable, or financial analysis role.
• Strong knowledge of billing processes, procedures, and systems.
• Proficiency with billing systems (e.g., Brightree, SAP, Oracle, QuickBooks) and Microsoft Office, particularly Excel.
• Brightree strongly preferred.
• Excellent analytical skills, with a high level of attention to detail and accuracy.
• Ability to manage multiple priorities and meet tight deadlines in a fast-paced environment.
• Strong problem-solving and communication skills, with the ability to collaborate effectively across departments.

Preferred Skills:

• Experience with large-scale enterprise billing systems (e.g., ERP systems).
• Familiarity with writing and developing work instructions (WI) and standard operating procedures (SOP).
• Knowledge of the durable medical equipment (DME) healthcare industry, particularly in revenue cycle management practices.
• Familiarity with Salesforce CRM.