[Hiring] RCM Billing Analyst @Pediatrix

Role Description

The Billing Analyst is responsible for analyzing, researching, and resolving issues related to the creation and submission of paper and electronic claims. Key responsibilities include:

• Working with the Business Systems Department to create effective clearinghouse edits responding to errors from electronic claims submissions.
• Monitoring claim errors until resolved.
• Identifying opportunities for new edits based on billing analysis.
• Daily review of Claims Manager, OBR, and GPMS edit reports.
• Reviewing errors with associates and re-training as necessary.
• Validating daily import of RDS/BS interface.
• Balancing Hash Totals and identifying any skipped and/or duplicated batches.
• Identifying and reporting system issues to IS.
• Working with IS to achieve timely resolution of all daily issues.
• Validating weekly uploads from SounData interface.
• Monitoring daily EPM Exception report and working with Practice to resolve any open issues.
• Balancing Hash Totals and identifying any failed transactions.
• Completing daily edit reports for OnBase scanning and QC scanning batches for validation of completeness.
• Continuously monitoring and auditing the billing control processes and operations.
• Performing coding clean-up when required.
• Performing end of month process.
• Performing testing for all system upgrades and validating upgrades in production once implemented.
• Maintaining strict confidentiality in accordance with HIPAA regulations and Company policy.
• Presenting a positive, professional appearance and conveying a professional demeanor in the performance of assigned duties.

Qualifications

• Associate's degree (A. A.) or equivalent from a two-year college or technical school.
• 2 years related experience and/or training; or equivalent combination of education and experience.
• Software proficiency in Word, Excel, Crystal, OBR, GPMS, RDS, BabySteps, SounData, Onbase, Master Database.

Benefits

• Comprehensive benefits in a vast array of plans that fit your life and lifestyle.
• Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA, and HSAs.
• 401k plan and Employee Stock Purchase Program.
• Some benefits provided at no cost, while others require a cost share between employees and the company.
• Voluntary plans available for selection with convenient payroll deductions.

Company Description

Pediatrix Medical Group is one of the nation’s leading providers of highly specialized health care for women, babies, and children. Since 1979, Pediatrix has grown from a single neonatology practice to a national, multispecialty medical group. Pediatrix-affiliated clinicians are committed to providing coordinated, compassionate, and clinically excellent services to women, babies, and children across the continuum of care, both in hospital settings and office-based practices. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality-improvement, and safety initiatives.