• Job Description

  Req#: 52658

  Department/Unit:

  Physicians Billing

  Work Shift:

  Day (United States of America)

  Salary Range: $21.78 - $34.85
  
  This position will work with Practice Departments/Divisions at Albany Medical Center on issues related to professional fee billing, MCPG and Practice operational processes and communications among Practice Departments/Divisions. Supervise and provide back up to all Provider Service Analysts and develop the analyst positions to complement and support a positive relationship between MCPG and the Practices.

  Responsibilities:

  • Supervise the Provider Service Representative in the generation and completion of provider credentialing packages for all new AMC physicians, including working with payers and the practices to ensure provider numbers are assigned by payers in a timely manner. Also ensure that the SMS Provider Master and IDX Provider Dictionaries are maintained in a timely and concise manner.
  • Act as the lead liaison to the Practice Administrators. Generate special ad hoc reports and facilitate the flow of information between the Practice Administrators and the AMC departments to resolve issues related to professional fee billing and insurance reimbursement. Provide the Practice Administrators, physicians, non-physician practitioners and administrative staff with comparative data and information needed to make decisions impacting the financial operation of their practices.
  • Act as a resource for MCPG and AMC Departments/Divisions on medical billing policy guidelines, reimbursement levels and group benefits to maximize reimbursement. Inform physicians, non-physician providers and administrative staff of changes in insurance reimbursement policy and standards.
  • Schedule regular on-site office visits, orientations, and seminars to enhance training and education to providers and their office staff. Remain familiar with office staff and identify new staff that may require orientation to AMC/MCPG policies and procedures to avoid delays and denials with professional fee billing.
  • Respond to and resolve questions regarding professional fee issues, on an individual or global basis, from physicians, non-physician providers, and administrative staff. Assist in identifying resources at MCPG to assist in answering questions or resolving concerns.
  • Conduct seminars and training programs for Departments/Divisions on issues related to professional fee billing.
  • Remain knowledgeable of all insurance products, policies and procedures, and State and Federal mandates and legislation, and through excellent communication skills, educate the importance of such to the Practice Administrators, physicians, non-physician practitioners, administrative staff, and MCPG staff.
  • Using spreadsheets, develop matrices and tabulate insurance payment data to establish insurance processing and payment trends. Examine insurance payment vouchers and other materials to identify patterns of rejections and denials.
  • Maintain confidentiality at all times.
  • Work additional hours as needed.

  Qualifications:

  • Associate' s Degree or High School Diploma/GED and a minimum of 5 years’ experience in customer service with specialization in Provider/Customer services in a healthcare industry is required.
  • Working knowledge and experience with provider professional fee insurance billing.
  • Certified Professional Coder (CPC) is required in this position
  • Computer experience, windows environment with proficiency in Microsoft Word and Excel is required.

  Thank you for your interest in Albany Medical Center!

  Albany Medical is an equal opportunity employer.

  This role may require access to information considered sensitive to Albany Medical Center, its patients, affiliates, and partners, including but not limited to HIPAA Protected Health Information and other information regulated by Federal and New York State statutes. Workforce members are expected to ensure that:

  Access to information is based on a “need to know” and is the minimum necessary to properly perform assigned duties. Use or disclosure shall not exceed the minimum amount of information needed to accomplish an intended purpose. Reasonable efforts, consistent with Albany Med Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification.

• About the company

  Albany Medical Center is the name of the umbrella organization over the Albany Medical Center Hospital and Albany Medical College in Albany, New York.

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