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RCM Billing Analyst

Role overview

Qualifications

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

Responsibilities

  • Analyze, research and resolve issues related to the creation and submission of paper and electronic claims
  • Work with Business Systems Department to create effective clearinghouse edits for electronic claims submissions
  • Monitor claim errors until resolved and identify opportunities for new edits based on billing analysis
  • Continuously monitor and audit billing control processes and operations

Key facts

Hard skills

Other skills

  • Microsoft Excel
  • Detail Oriented
  • Communication
  • Problem Solving
  • Teamwork

About the company

Pediatrix Medical Group logo

Pediatrix Medical Group

Hospitals & Health Care

Pediatrix® Medical Group, Inc. (Pediatrix) is the nation’s leading provider of physician services. 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. Specialties include obstetrics, maternal-fetal medicine and neonatology complemented by more than 20 pediatric subspecialties, as well as pediatric primary and urgent care clinics. The group’s high-quality, evidence-based care is bolstered by significant investments in research, education, quality improvement and safety initiatives. The physician-led company was founded in 1979 as a single neonatology practice and today provides its highly specialized and often critical care services through more than 5,000 affiliated physicians and other clinicians in 37 states.

Company details

Company typeXLarge
IndustryHospitals & Health Care
Company size5001 - 10000

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Job description

Overview:

 We have an exciting opportunity for a Revenue Cycle Management (RCM) Billing Analyst to join our team. Pediatrix Medical Group is a physician lead organization, and we are one of the nation’s largest providers of prenatal, neonatal and pediatric services.

Talented business professionals from diverse backgrounds choose Pediatrix because we are an exciting and innovative company that focuses on a team approach to improve the lives of patients everywhere.  We offer a diverse range of opportunities, competitive salaries and benefits, and a commitment to clinical excellence, we are confident that you'll love being a part of the Pediatrix team. 

Responsibilities:

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 which respond to errors generated from electronic claims submissions. Monitors claim errors until resolved. Identifies opportunities for new edits based on billing analysis.

  • Daily review Claims Manager, OBR and GPMS edit reports.
  • Review errors with associates and re-train as necessary.  Monitor errors until resolved.
  • Identify opportunity for new edits based on billing analysis.
  • Validate daily import of RDS/BS interface.
  • Balance Hash Totals and identify any skipped and/or duplicated batches. 
  •  Identify and report to IS any system issues. 
  •  Work with IS to achieve timely resolution of all daily issues.
  • Validate weekly uploads from SounData interface. 
  • Monitor daily EPM Exception report and work with Practice to resolve any open issues.
  • Balance Hash Totals and identify any failed transactions. 
  • Identify and report any system issues to IS.  Work with IS to achieve timely resolution of all outstanding daily issues.
  • Complete daily edit reports for OnBase scanning. QC scanned batches for validation of completeness.
  • Continuously monitor and audit the billing control processes and operations.
  • Perform coding clean-up when required.
  • Perform end of month process.
  • Perform testing for all system upgrades. Validate upgrades in production once implemented.
  • Maintain strict confidentiality in accordance with HIPAA regulations and Company policy.
  • Presents a positive, professional appearance and conveys a professional demeanor in the performance of assigned duties.,
Qualifications: Education/Experience:
  • Associate's degree (A. A.) or equivalent from two-year college or technical school
  • 2 years related experience and/or training; or equivalent combination of education and experience. 

Software:

Word, Excel, Crystal, OBR, GPMS, RDS, BabySteps, SounData, Onbase, Master Database.

Benefits and Compensation:

Take great care of the patient, every day and every way.TM At Pediatrix & Obstetrix, that’s not only our motto at work each day; it’s also how we view our employees and their families. We know that our greatest asset is YOU. 

We take pride in offering comprehensive benefits in a vast array of plans that fit your life and lifestyle, supporting your health and overall well-being. Benefits offered include, but are not limited to: Medical, Dental, Vision, Life, Disability, Healthcare FSA, Dependent Care FSA and HSAs, as well as a 401k plan and Employee Stock Purchase Program. Some benefits are provided at no cost, while others require a cost share between employees and the company. Employees may also select voluntary plans and pay for these benefits through convenient payroll deductions. Our benefit programs are just one of the many ways Pediatrix & Obstetrix helps our employees take care of themselves and their families. 

About Us:

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. 

Please Note: Fraudulent job postings/job scams are becoming increasingly common. All genuine Pediatrix job postings can be found through the Pediatrix Careers site: www.pediatrix.com/careers.

#LI-Remote

Pediatrix is an Equal Opportunity Employer:

All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or veteran status.

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MR

Marcus Rivera

Chief Revenue Officer

m.rivera@company.com
linkedin.com/in/marcusrivera
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