Interpath Laboratory

  • Billing Systems and Reimbursement Analyst

    Location US-OR-Pendleton
    Job ID
    2019-3201
    # Positions
    1
    Category
    Administrative/Clerical
    Schedule
    Monday-Friday
  • Equal Opportunity Statement

    EOE Disabled/Veteran

    Expectations for all Employees

    Support the organization's mission, vision, and values by exhibiting an ongoing commitment to the highest standards in all phases of company's operations. Assumes service-oriented attitude to gain a sense of pride and accomplishment. Accepts the team approach with dedication and commitment towards all work performed.

    Position Purpose and Summary

    The Billing Systems and Reimbursement Analyst is responsible for the clinic practice management system (Greenway Intergy) and connectivity with associated subsystems (clearinghouse, payment portals, statement vendors, etc.). This position will provide end-user support of systems and software, work with supervisors and managers to create and implement solutions, complete projects, serve as liaison to IT and assist with corporate reporting and documentation requirements. This position is also responsible for optimizing clinic reimbursement in accordance with Federal and state requirements and all third party payer contracts.  Responsible for retrospective review and data mining of information from Intergy and other billing systems for the identification, research, analysis, prevention and recovery of underpayments. 

    Minimum Qualifications

    Education: High school graduate or equivalent.

     

    Licensure/Certification: N/A

     

    Experience:

    • Minimum 5 years related work experience required
    • Familiarity with healthcare practice management systems and databases is required
    • Understanding of medical practice billing, revenue cycle and reimbursement required
    • Ability to review and understand government and managed care contract language, payment methodologies and government regulations. Balancing payment transactions against contract rates and terms is strongly desired.
    • Familiar with ICD-10, CPT Coding, ANSI 5010 837P formats, 835 Reason Codes, etc.
    • Demonstrated success in utilizing problem solving and communication skills to diagnose problems and resolve complicated issues
    • Proficiency in Excel and Databases including extracting and merging data from multiple sources

    General Areas of Responsibility

    General Areas of Responsibility:

     

    • Train and coach all new and existing insurance billing analysts and support staff on existing procedures (i.e. eligibility checking, payment posting, appeals, etc.). Communicate technical guidance and instruction to users on the use of software applications and systems.
    • Perform systematic daily, weekly and monthly processes, documentation and reporting as required by billing manager
    • Assist analysts with troubleshooting payer issues, such as denials, rejections, delayed responses, missing EOBs/ERAs/EFTs, missing claim files, etc.
    • Troubleshoot and resolve software and connectivity problems, including user access and component configuration.
    • Manage systems projects, including ability to plan, implement, test (validate), and troubleshoot system software.
    • Maintain rule configurations in systems, such as Intergy, RemitIQ and other systems
    • Work with IT software team to maintain rule configurations in UiPath and other systems
    • Maintain high-level working knowledge of Intergy as an Administrator.
    • Maintain Medicare Local and National Coverage Determinations in Intergy.
    • Manage eligibility website user access, passwords, etc.
    • Maintain confidentiality with regard to the information being processed, stored or accessed by the network.
    • Serve as a liaison between IT staff, including networking to ensure connectivity and compatibility between systems.
    • Responsibilities may require evening and weekend work in response to needs of the systems being supported.

    Specific Areas of Responsibility

    Specific Areas of Responsibility:

    • Assist billing supervisor and manager in documenting existing procedures as well as formulating and implementing new policies and procedures.
    • Participate in testing of billing system upgrades and new system implementations.
    • Proactively identify, research and analyze claim underpayment root causes and trends; compare reimbursement rates with existing contracts on file, assist in the resolution of underpayments and/or improvement of future reimbursements.
    • Create and maintain statistical reports and databases to identify all reimbursement issues, track reasons, identify trends and problem payers
    • Communicate problematic variances, delays, and any other issues impacting reimbursement to billing supervisor and manager.
    • Function as a resource to outside departments to provide reimbursement information toeducate, reduce and eliminate future underpayments (i.e. price increase recommendations, etc.
    • Provide excellent customer service in response to requests or inquiries from other departments within the organization, as well as external parties.
    • Participate in departmental meetings as well as special projects and represent the Business Office as assigned.
    • Understand and adhere to HIPAA, HITECH and Medicare compliance, policies and regulations
    • Perform other projects as assigned.
    • Follow all established I.Q. protocols.

    OSHA Category

      

    General Physical Requirements

      • Must be able to lift 30-40 lbs.
      • Typically sits for extended period of times.

     

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