Account Representative jobs at Northwell Health - 72 jobs

Monitors the activities and performance of physician practices to ensure that billing related functions are performed in an efficient manner consistent with department policies and procedures. Job Responsibility + Interfaces with physicians and administrators to ensure financial growth and stability; apprises physicians of new and revised procedures. + Monitors accuracy of fee structure and reimbursement payment schedules from third party payers, all cash payment deposits and refunds. + Acts as resource person for resolution of complex billing situations. + Guides billing/clerical staff regarding billing and office/clerical functions. + Coordinates clinical documentation requests to business office to ensure timely appeals. + Develops and implements policies and procedures to facilitate billing and maximize case collections. + Reviews and recommends improvements for financial management of each billing area. + Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions. Job Qualification + Associate's Degree required, or equivalent combination of education and related experience. + 3-5 years of relevant experience, required. ***Additional Salary Detail** The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future.When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity). The salary range for this position is $44450-$69340/year It is Northwell Health's policy to provide equal employment opportunity and treat all applicants and employees equally regardless of their age, race, creed/religion, color, national origin, immigration status or citizenship status, sexual orientation, military or veteran status, sex/gender, gender identity, gender expression, disability, pregnancy, genetic information or genetic predisposition or carrier status, marital or familial status, partnership status, victim of domestic violence, sexual or other reproductive health decisions, or other characteristics protected by applicable law.

The Procedural Billing Specialist I is responsible for multiple components of the complex billing and coding process for specialized procedures, including Accounts Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with responses to problems or questions regarding benefit eligibility and reimbursement procedures. S/he coordinates activities related to data entry of billing, and demonstrates proficiency in analysis and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. Reports to Billing Manager/Revenue Cycle Manager. *Please note that this is NOT a remote opportunity, and will be onsite. **Qualifications** + Associates Degree preferred + 5 years experience in medical billing or health claims, with experience in IDX billing systems in a health care or insurance environment, and strong familiarity with ICD/CPT coding + Licensing: None but CPC strongly preferred (required in Oncology) Non-Bargaining Unit, R45 - Orthopaedics Roosevelt - ISM, Icahn School of Medicine **Responsibilities** + Performs specialized coding services for inpatient and outpatient medical office visits. Reviews physician coding and provides updates. + Provides comprehensive financial counseling to patients. Responsible for setting patient expectations, discussion of financial options, payment plans, one-time settlements and resolution of unpaid balances. + Discusses with patients the details concerning their insurance coverage and financial implications of out-of-network benefits, including pre-determination of benefits, appeals and/or pre-certification limitations. + Develop and manages fee schedules and for self-pay patients. + Processes Workers Compensation claims and addresses/resolves all discrepancies. + Conducts specialized negotiations with insurance companies. Brokers and negotiates with insurance carriers. Establishes a network of key representatives within the insurance pre-certification units to establish open lines of communication for future service negotiation. + Verifies insurance and registration data for scheduled office, outpatient, and inpatient procedures. Reviews encounter forms for accuracy. Responsible for obtaining pre-certifications for scheduled admissions. + Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. + Posts all payments in IDX. Runs and works missing charges, edits, denials list and processes appeals. Posts denials in IDX on a timely basis. + Provides comprehensive denial management to facilitate cash flow. Tracks, quantifies and reports on denied claims. + Directs and assists with responses to problems or questions regarding benefit eligibility and reimbursement procedures. + Researches unidentified or misdirected payments. + Works credit balance report to ensure adherence to government regulations/guidelines. + Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations. + Identifies and resolves credentialing issues for department physicians. + Maintains a thorough understanding of medical terminology through participation in continuing education programs to effectively apply ICD-10-CM/PCS, CPT and HCPCS coding guidelines to inpatient and outpatient diagnoses and procedures. + Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns. + Mentors less experienced billing staff and assists Billing Manager/Revenue Cycle Manager in staff training. + Other identified duties as assigned. **About Us** **Strength through Unity and Inclusion** The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai's unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. **About the Mount Sinai Health System:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's "Best Children's Hospitals" ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's Best Smart Hospitals" ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. **Equal Opportunity Employer** The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. **Compensation Statement** Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $66482.07 - $87505.56 Annually. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

Department/Unit: AMHS - Self Pay Billing Office Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64The SBO Customer Service Billing Associate is responsible for providing customer service to patients and families who have received services at any of the five main campus locations within the Albany Med Health System including 125 + practice locations. The department is responsible for $65-70M in total Self-Pay AR. The Customer Service Billing Associate is the primary point of contact for customer/patient inquiries, receiving in excess of 100 calls per day. This position collects payments, assists with insurance inquiries, provides account status, and will escalate calls to management as needed. This role requires professional communication, accuracy, and problem-solving skills. Essential Duties and Responsibilities Manage inbound and outbound calls with professionalism and empathy, addressing customer inquiries, including those related to CRM systems-to ensure accurate and timely support Assist patients in reviewing and selecting appropriate payment plan options within the Albany Med Health System guidelines, including guidance on available Financial Aid programs Maintain strong listening skills; ability to de-escalate in difficult or emotional customer interactions. Review credit balances; process refund requests. Accurately update, add, or remove patient insurance and demographic information to ensure up-to-date records and seamless billing processes and identify root causes of data discrepancies Manage assigned work queues and perform intradepartmental workflow tasks as needed to support efficient operations and cross-functional collaboration Meet daily/weekly productivity standards with acceptable QA results. Manage a cash drawer as needed. Process attorney, internal, bankruptcy, and insurer requests in accordance with organizational policies and regulatory requirements Perform cross-functional coordination with billing, legal, and insurance teams to ensure accurate processing and issue resolution Additional responsibilities as required Qualifications High School Diploma/G.E.D. - required Associate's Degree - preferred 1-2 years of relevant customer service or support experience - preferred Proven capability to self-manage and take initiative in completing assignments with accountability Excellent verbal and written communication Strong attention to detail; ability to follow processes accurately Basic understanding of relevant financial/billing terms Effectively defuse high-stress customer interactions to achieve positive outcomes Familiarity with CRM or customer support software Ability to manage time effectively and complete multiple tasks timely Some medical terminology knowledge Equivalent combination of relevant education and experience may be substituted as appropriate. Physical Demands Standing - Occasionally Walking - Occasionally Sitting - Constantly Lifting - Rarely Carrying - Rarely Pushing - Rarely Pulling - Rarely Climbing - Rarely Balancing - Rarely Stooping - Rarely Kneeling - Rarely Crouching - Rarely Crawling - Rarely Reaching - Rarely Handling - Occasionally Grasping - Occasionally Feeling - Rarely Talking - Constantly Hearing - Constantly Repetitive Motions - Frequently Eye/Hand/Foot Coordination - Frequently Working Conditions Extreme cold - Rarely Extreme heat - Rarely Humidity - Rarely Wet - Rarely Noise - Occasionally Hazards - Rarely Temperature Change - Rarely Atmospheric Conditions - Rarely Vibration - Rarely Thank you for your interest in Albany Medical Center! Albany Medical Center 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 Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. 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.

Department/Unit: Patient Engagement Center Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64The Pre-Service Representative I is responsible for the initial touchpoint of our patient population to provide an exceptional patient experience with assisting in scheduling of services for our Hospital and Practice. This requires ability to work in a high-volume, fast paced environment. Understanding of complex scheduling needs of our patients in an empathetic, compassionate manner is critical. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to collect patient financial obligation pre-services. The Pre-Service Representative I, after one year in the position and based on performance and success in position, has ability to be promoted to Pre-Service Representative II as Career Ladder requirements indicate. Responsibilities: Maintain strict adherence to the Albany Medical Center Confidentiality policy. Incorporate Albany Medical Center Customer Service Standards and demonstrates commitment toward meeting and exceeding the needs of our customers into daily activities. Comply with all Albany Medical Center Policies. Comply with behavioral expectations of the department. Maintain courteous and effective interactions with colleagues. Demonstrate an understanding of the job description, performance expectations, and competency assessment. Participate in departmental and/or interdepartmental quality improvement activities. Participate in the training and onboarding of new staff members Participate in and successfully completes Mandatory Education. Perform all other duties as needed or directed to meet the needs of the department. Adheres to AMC Corporate Compliance Plan Qualifications: High School Diploma 1 - 2 years winning customer service personality with ability to engage patients and customers via telephone with superior patient experience. Insurance knowledge, preferred 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.

The Billing Specialist is responsible for multiple components of the billing & coding process, including Accounts Receivable, Charge Entry, Edits and Payment Posting. Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution. **Qualifications** + Associates Degree or high school diploma/GED plus 3 years of relevant experience + Certified coder required + Experience in medical billing or health claims, with experience in EPIC & IDX billing systems in a health care or insurance environment preferred **Responsibilities** 1. Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and procedures. 2. Extract CPT codes form operative reports and reconcile with the providers bill, to make sure the providers a coding optimally. 3. Collaborate with other coders and provide education/feedback to the providers on optimal billing and coding for outpatient encounters, in-patient consults and procedures/surgeries. 4. Provide orientation to the new providers about relevant billing and coding for neurosurgical encounters 5. Run reports for missing charges and collaborate with providers/practices to ensure timely charge entry. 6. May run and work missing charges, edits, denials list and process appeals. Posts denials in EPIC/IDX on a timely basis. 7. Posts all payments in IDX using approved methodologies. 8. May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff. 9. Works TES, BAR and eCommerce edits for the division, department and physicians. Proficient in moderate to complex encounters and problematic accounts. 10. Works daily Accounts Receivable accounts via online workfile and/or hard-copy reports; checks claims status, re-submits claims, and writes appeal letters. 11. Researches unidentified checks sent to other departments. 12. Works credit balance report to ensure adherence to government regulations/guidelines. 13. Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations. 14. Identifies and resolves credentialing issues for department physicians. 15. Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns. 16. Mentors less experienced Billing staff and assists Billing Manager/FPA Manager in training new staff. 17. May approve EPIC work queue for outpatient encounters. 18. Verifies insurance and registration data for scheduled office, outpatient, and inpatient encounters and scheduled surgeries; reviews encounter forms for accuracy. May be responsible for obtaining pre-certification for scheduled surgeries and admissions. 19. May approve Patient Keeper work queue for inpatient encounters. 20. May be responsible for collection of time of service payments, and maintaining daily transaction record of collected payments. 21. May prepare TOS deposits in Sinai Central. 22. Maintains working knowledge and currency in third party payor requirements. **About Us** **Strength through Unity and Inclusion** The Mount Sinai Health System is committed to fostering an environment where everyone can contribute to excellence. We share a common dedication to delivering outstanding patient care. When you join us, you become part of Mount Sinai's unparalleled legacy of achievement, education, and innovation as we work together to transform healthcare. We encourage all team members to actively participate in creating a culture that ensures fair access to opportunities, promotes inclusive practices, and supports the success of every individual. At Mount Sinai, our leaders are committed to fostering a workplace where all employees feel valued, respected, and empowered to grow. We strive to create an environment where collaboration, fairness, and continuous learning drive positive change, improving the well-being of our staff, patients, and organization. Our leaders are expected to challenge outdated practices, promote a culture of respect, and work toward meaningful improvements that enhance patient care and workplace experiences. We are dedicated to building a supportive and welcoming environment where everyone has the opportunity to thrive and advance professionally. Explore this opportunity and be part of the next chapter in our history. **About the Mount Sinai Health System:** Mount Sinai Health System is one of the largest academic medical systems in the New York metro area, with more than 48,000 employees working across eight hospitals, more than 400 outpatient practices, more than 300 labs, a school of nursing, and a leading school of medicine and graduate education. Mount Sinai advances health for all people, everywhere, by taking on the most complex health care challenges of our time - discovering and applying new scientific learning and knowledge; developing safer, more effective treatments; educating the next generation of medical leaders and innovators; and supporting local communities by delivering high-quality care to all who need it. Through the integration of its hospitals, labs, and schools, Mount Sinai offers comprehensive health care solutions from birth through geriatrics, leveraging innovative approaches such as artificial intelligence and informatics while keeping patients' medical and emotional needs at the center of all treatment. The Health System includes more than 9,000 primary and specialty care physicians; 13 joint-venture outpatient surgery centers throughout the five boroughs of New York City, Westchester, Long Island, and Florida; and more than 30 affiliated community health centers. We are consistently ranked by U.S. News & World Report's Best Hospitals, receiving high "Honor Roll" status, and are highly ranked: No. 1 in Geriatrics, top 5 in Cardiology/Heart Surgery, and top 20 in Diabetes/Endocrinology, Gastroenterology/GI Surgery, Neurology/Neurosurgery, Orthopedics, Pulmonology/Lung Surgery, Rehabilitation, and Urology. New York Eye and Ear Infirmary of Mount Sinai is ranked No. 12 in Ophthalmology. U.S. News & World Report's "Best Children's Hospitals" ranks Mount Sinai Kravis Children's Hospital among the country's best in several pediatric specialties. The Icahn School of Medicine at Mount Sinai is ranked No. 11 nationwide in National Institutes of Health funding and in the 99th percentile in research dollars per investigator according to the Association of American Medical Colleges. Newsweek's "The World's Best Smart Hospitals" ranks The Mount Sinai Hospital as No. 1 in New York and in the top five globally, and Mount Sinai Morningside in the top 20 globally. **Equal Opportunity Employer** The Mount Sinai Health System is an equal opportunity employer, complying with all applicable federal civil rights laws. We do not discriminate, exclude, or treat individuals differently based on race, color, national origin, age, religion, disability, sex, sexual orientation, gender, veteran status, or any other characteristic protected by law. We are deeply committed to fostering an environment where all faculty, staff, students, trainees, patients, visitors, and the communities we serve feel respected and supported. Our goal is to create a healthcare and learning institution that actively works to remove barriers, address challenges, and promote fairness in all aspects of our organization. **Compensation Statement** Mount Sinai Health System (MSHS) provides a salary range to comply with the New York City Law on Salary Transparency in Job Advertisements. The salary range for the role is $20.4566 - $30.685 Hourly. Actual salaries depend on a variety of factors, including experience, education, and hospital need. The salary range or contractual rate listed does not include bonuses/incentive, differential pay or other forms of compensation or benefits.

The Billing Specialist is responsible for multiple components of the billing & coding process, including Accounts Receivable, Charge Entry, Edits and Payment Posting. Proficient in these processes to ensure accurate and timely payment of claims and collection, and in analysis and problem resolution. Associates Degree or high school diploma/GED plus 3 years of relevant experience Certified coder required Experience in medical billing or health claims, with experience in EPIC & IDX billing systems in a health care or insurance environment preferred Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. Ensures charges are entered/processed in accordance with policies and procedures. Extract CPT codes form operative reports and reconcile with the providers bill, to make sure the providers a coding optimally. Collaborate with other coders and provide education/feedback to the providers on optimal billing and coding for outpatient encounters, in-patient consults and procedures/surgeries. Provide orientation to the new providers about relevant billing and coding for neurosurgical encounters Run reports for missing charges and collaborate with providers/practices to ensure timely charge entry. May run and work missing charges, edits, denials list and process appeals. Posts denials in EPIC/IDX on a timely basis. Posts all payments in IDX using approved methodologies. May perform specialty coding for services and medical office visits and review physician coding and provide updated to physicians and staff. Works TES, BAR and eCommerce edits for the division, department and physicians. Proficient in moderate to complex encounters and problematic accounts. Works daily Accounts Receivable accounts via online workfile and/or hard-copy reports; checks claims status, re-submits claims, and writes appeal letters. Researches unidentified checks sent to other departments. Works credit balance report to ensure adherence to government regulations/guidelines. Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations. Identifies and resolves credentialing issues for department physicians. Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns. Mentors less experienced Billing staff and assists Billing Manager/FPA Manager in training new staff. May approve EPIC work queue for outpatient encounters. Verifies insurance and registration data for scheduled office, outpatient, and inpatient encounters and scheduled surgeries; reviews encounter forms for accuracy. May be responsible for obtaining pre-certification for scheduled surgeries and admissions. May approve Patient Keeper work queue for inpatient encounters. May be responsible for collection of time of service payments, and maintaining daily transaction record of collected payments. May prepare TOS deposits in Sinai Central. Maintains working knowledge and currency in third party payor requirements.

Review Medical charts and documentation within but not limited to the facility EMR, Epic, to ensure that all Physician charges are captured in a timely and complaint manner. Work with the Faculty Practice Group Compliance Manager and Administrator to ensue all FPG revenue is captured. Responsibilities Maintains a working knowledge of CPT and ICD-9/10CM coding principles, governmental regulations, protocols and third party requirements regarding coding and billing documentation. Review and code patient encounters in EPIC with appropriate CPT, ICD-9CM, ICD-10CM and HCPCS codes for a multi-specialty group practice. Services include inpatient, outpatient, Emergency, and ambulatory surgery for both E & M encounters and procedures. Utilizes the Correct Coding Initiative (CCI) edits for accurate assigning of code and make use of the Local Coverage Determinations for medical necessity. Identify any areas for improvement in documentation as related to compliance and billing. Query and/or meet with physicians regarding documentation and deficiencies. Review edits, denials and requests for additional information from the accounts receivable team to ensure the time processing of claims and all revenue is captured. Maintains daily logs of coded work. Assures that operative reports and other third party regulatory information are pertinent to coding requirements. Works with management and the billing vendor daily, on edit list and/or requests for additional information as to reduce denials and accounts receivable. Attends various classes, seminars or trainings to keeping current with CPC certification. Reviews, modifies and recommends changes to policies and procedures to improve coding. Performs other related duties as assigned. Qualifications Requires a level of understanding that is obtained or acquired through the completion of a High School Diploma. Knowledge of Medical Terminology, ICD-9CM, ICD-10CM and CPT 4 coding certification obtained by completion of a certificate course with CPC / CCS-P credentials. At least six months coding experience preferred. Certified Professional Coder/AAPC. Ability to use computer. Average dexterity and knowledge of software applications such as Microsoft, Excel, etc. Ability to work independently with minimal supervision at a high level of productivity. Ability to examine scanned documents, such as operative reports to determine accuracy of coding. Ability to prioritize own work and proceed with minimum supervision. Ability to maintain strictest confidentiality according to HIPAA regulations. Ability to work effectively with others as well as physicians. Be able to perform effectively with various commercial and hospital computer applications.

The Procedural Billing Specialist I is responsible for multiple components of the complex billing and coding process for specialized procedures, including Accounts Receivable, Charge Entry, Edits and Payment Posting. This individual facilitates claims processing and payments services rendered by physicians and assists with responses to problems or questions regarding benefit eligibility and reimbursement procedures. S/he coordinates activities related to data entry of billing, and demonstrates proficiency in analysis and problem resolution to ensure accurate and timely payment of claims and collection. The Specialist works directly with the Department Administrator. Reports to Billing Manager/Revenue Cycle Manager. *Please note that this is NOT a remote opportunity, and will be onsite. Responsibilities Performs specialized coding services for inpatient and outpatient medical office visits. Reviews physician coding and provides updates. Provides comprehensive financial counseling to patients. Responsible for setting patient expectations, discussion of financial options, payment plans, one-time settlements and resolution of unpaid balances. Discusses with patients the details concerning their insurance coverage and financial implications of out-of-network benefits, including pre-determination of benefits, appeals and/or pre-certification limitations. Develop and manages fee schedules and for self-pay patients. Processes Workers Compensation claims and addresses/resolves all discrepancies. Conducts specialized negotiations with insurance companies. Brokers and negotiates with insurance carriers. Establishes a network of key representatives within the insurance pre-certification units to establish open lines of communication for future service negotiation. Verifies insurance and registration data for scheduled office, outpatient, and inpatient procedures. Reviews encounter forms for accuracy. Responsible for obtaining pre-certifications for scheduled admissions. Enters office, inpatient, and/or outpatient charges with accurate data entry of codes. Posts all payments in IDX. Runs and works missing charges, edits, denials list and processes appeals. Posts denials in IDX on a timely basis. Provides comprehensive denial management to facilitate cash flow. Tracks, quantifies and reports on denied claims. Directs and assists with responses to problems or questions regarding benefit eligibility and reimbursement procedures. Researches unidentified or misdirected payments. Works credit balance report to ensure adherence to government regulations/guidelines. Analyzes claims system reports to ensure underpayments are correctly identified and collected from key carriers. Reviews and resolves billing issues and provides recommendations. Identifies and resolves credentialing issues for department physicians. Maintains a thorough understanding of medical terminology through participation in continuing education programs to effectively apply ICD-10-CM/PCS, CPT and HCPCS coding guidelines to inpatient and outpatient diagnoses and procedures. Meets with practice management, leadership and/or physicians on a scheduled basis to review Accounts Receivable and current billing concerns. Mentors less experienced billing staff and assists Billing Manager/Revenue Cycle Manager in staff training. Other identified duties as assigned. Qualifications Associates Degree preferred 5 years experience in medical billing or health claims, with experience in IDX billing systems in a health care or insurance environment, and strong familiarity with ICD/CPT coding Licensing: None but CPC strongly preferred (required in Oncology) Non-Bargaining Unit, R45 - Orthopaedics Roosevelt - ISM, Icahn School of Medicine

Review Medical charts and documentation within but not limited to the facility EMR, Epic, to ensure that all Physician charges are captured in a timely and complaint manner. Work with the Faculty Practice Group Compliance Manager and Administrator to ensue all FPG revenue is captured. Responsibilities Maintains a working knowledge of CPT and ICD-9/10CM coding principles, governmental regulations, protocols and third party requirements regarding coding and billing documentation. Review and code patient encounters in EPIC with appropriate CPT, ICD-9CM, ICD-10CM and HCPCS codes for a multi-specialty group practice. Services include inpatient, outpatient, Emergency, and ambulatory surgery for both E & M encounters and procedures. Utilizes the Correct Coding Initiative (CCI) edits for accurate assigning of code and make use of the Local Coverage Determinations for medical necessity. Identify any areas for improvement in documentation as related to compliance and billing. Query and/or meet with physicians regarding documentation and deficiencies. Review edits, denials and requests for additional information from the accounts receivable team to ensure the time processing of claims and all revenue is captured. Maintains daily logs of coded work. Assures that operative reports and other third party regulatory information are pertinent to coding requirements. Works with management and the billing vendor daily, on edit list and/or requests for additional information as to reduce denials and accounts receivable. Attends various classes, seminars or trainings to keeping current with CPC certification. Reviews, modifies and recommends changes to policies and procedures to improve coding. Performs other related duties as assigned. Qualifications Requires a level of understanding that is obtained or acquired through the completion of a High School Diploma. Knowledge of Medical Terminology, ICD-9CM, ICD-10CM and CPT 4 coding certification obtained by completion of a certificate course with CPC / CCS-P credentials. At least six months coding experience preferred. Certified Professional Coder/AAPC. Ability to use computer. Average dexterity and knowledge of software applications such as Microsoft, Excel, etc. Ability to work independently with minimal supervision at a high level of productivity. Ability to examine scanned documents, such as operative reports to determine accuracy of coding. Ability to prioritize own work and proceed with minimum supervision. Ability to maintain strictest confidentiality according to HIPAA regulations. Ability to work effectively with others as well as physicians. Be able to perform effectively with various commercial and hospital computer applications.

Department/Unit: Patient Billing Service Work Shift: Day (United States of America) Salary Range: $65,102.17 - $100,908.37Salary Range: $28.99 - $46.39 The Supervisor is responsible for the day to day staff oversight and daily billing operations of the Billing Unit in the Hospital Patient Financial Services Department. This work unit is comprised of 25 ASA level staff. The Supervisor shall use independent judgment and discretion as it relates to executing all aspects of work within the unit. The Supervisor shall ensure the following tasks and areas are managed per policy on a daily basis Validate timely follow up on all outstanding claims Validate timely submission of all payor appeals for claim denied erroneously Validate timely resolution of claim errors Validate timely and accurate refund processing Daily monitoring of staff productivity to ensure daily goals are met and accounts worked per policy Complete management of all PL time and KRONOS requirements Coordination of time usage amongst payor teams to ensure adequate workload coverage Promote team building and intervene to resolve disputes Strong oral and written communication skills Strong Soarian Financial skills Proficiency with Microsoft Office Applications Intermediate knowledge of medical terminology Ensure daily team compliance with Professional Image Standard Organization and prioritization of tasks Work daily to meet all departmental and institutional goals Conduct new hire orientation per policy Essential Functions and Responsibilities New Policy and Procedure development Continued Policy and Procedure review and modification Ensure that staff are trained on payor contracts Ensure claims are paid per contract terms Ensure that all contractual allowances are accurate and timely Preparation of staff and participation in all payor meetings Maintain proficiency and timely communication of all third party payor and federal and state government claim submission regulation Monthly review of chargemaster CPT, HCPCS and revenue coding Conduct timely and routine staff training and remediation Ensures staff meetings are held monthly with assistance from Manager Cooperates and works with Manager and other hospital supervisory and management personnel to resolve revenue cycle issues and process weaknesses to ensure timely and accurate claim submission Document best practices and recommend opportunities for continuous improvement Ensure that all Med Assets worklists are worked accurately and timely Monitor and remediation of the FIX worklist process Ensure that all month end processing is completed timely. The Billing Unit Supervisor works independently and is self-directed. The Supervisor may seek guidance from the Billing Unit Managers when needed. It is expected that the Supervisor initiates independent thought and actions consistent with departmental and institutional policies and procedures. Core functions of the unit and department are monitored by all levels of management. The expectation is that the Supervisor reports out and ensures management is aware of all variances and all proposed resolution plans. 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.

Department/Unit: Patient Access Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64The Access Service Representative I is responsible for the capture of demographic and insurance information either by telephone or patient facing. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. Must be comfortable in the collection of financial responsibility from the patient based on eligibility response or estimate for services. Essential Duties and Responsibilities Must have flexibility to work Saturdays, as needed/required Responsible for accurate patient look up to ensure correct patient is being registered. Responsible for discerning demographic and insurance information to ensure accurate registration Responsible to interpret information received from Insurance Payer regarding patient's eligibility and financial responsibility Responsible for discussing financial obligation of patient and collect via cash, credit card or check Responsible for explaining regulatory forms and answer questions from patient; obtain signatures accordingly Responsible for scanning or managing online form template to maintain the Electronic Health Record Comprehend Federal, State, Third Party Payer regulations as it pertains to a hospital registration. Ability to work in multiple systems during a telephone call or patient facing interaction to complete an accurate registration and support clinical workflow. Functional Competencies Social and Emotional Intelligence Ability to deal with a diverse population including critically injured, mentally disturbed and belligerent Patient centric - customer service Conflict Management Team-oriented support Adaptable to high-stress situation Excellent communication skill Qualifications High School Diploma/G.E.D. - required 1-3 years applicable experience; customer service and strong computer skill - required Hospital or Clinic setting office experience - preferred Proven customer service skill with ability to exceed expectations Ability to multi-task in stressful and high patient volume unit Ability to learn in classroom setting; utilizing resources Ability to remain composed under pressure Ability to review information and draw appropriate conclusion Good judgement and ability to be resourceful to problem solve; escalate issues as needed Team minded worth ethic Equivalent combination of relevant education and experience may be substituted as appropriate. Physical Demands Standing - Occasionally Walking - Occasionally Sitting - Constantly Talking - Constantly Hearing - Constantly Repetitive Motions - Constantly Thank you for your interest in Albany Medical Center! Albany Medical Center 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 Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. 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.

Department/Unit: Admitting Operations Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64The Pre-Service Representative I is responsible for the initial touchpoint of our patient population to provide an exceptional patient experience with assisting in scheduling of services for our Hospital and Practice. This requires ability to work in a high-volume, fast paced environment. Understanding of complex scheduling needs of our patients in an empathetic, compassionate manner is critical. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to collect patient financial obligation pre-services. The Pre-Service Representative I, after one year in the position and based on performance and success in position, has ability to be promoted to Pre-Service Representative II as Career Ladder requirements indicate. Education: HS Graduate Licensure, Certification & Registration: None Experience: 1 - 2 years Winning customer service personality with ability to engage patients and customers via telephone with superior patient experience. Insurance knowledge, preferred Skills, Knowledge & Abilities: Proven customer service skill with ability to exceed expectations Ability to multi-task in stressful and high patient volume unit Must be able to manage pressure of very tight timeframes to execute task Ability to learn in classroom, utilizing resources Ability to maintain composure under pressure Ability to review information and draw appropriate conclusion Good judgement and ability to be resourceful to problem solve; escalate issues as needed Team minded worth ethic Demonstrated ability interpret patient's insurance benefits and apply the applicable contractual obligations 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.

Department/Unit: Patient Engagement Center Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64Salary Range: $18.00 - $23.79 The Patient Engagement Liaison is the FIRST contact to Albany Med via telephone, thus first touchpoint in our Patient's Experience. This first impression must be received in a Compassionate and Respectful manner; engaging the caller in a professional manner. The critical role of the Patient Engagement Liaison is to ensure our patients and provider requests for services are triaged expeditiously and accurately to need. Additionally, receive information from patients and providers, via telephone and fax, and review and assess how to manage the incoming information. The position requires high degree of concentration, information retention, high volume workflow and quick turnaround time of telephone call and fax information. Responsibilities: Ability to handle high volume workload and stressful environment Strong ability to multi-task and prioritize workload Ability to engage patients/customers in a calm, respectful manner; regardless of tone or attitude of patient/customer via telephone Demonstrated attention to detail with minimal error 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.

Department/Unit: Patient Engagement Center Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64 The Pre-Service Representative I is responsible for the initial touchpoint of our patient population to provide an exceptional patient experience with assisting in scheduling of services for our Hospital and Practice. This requires ability to work in a high-volume, fast paced environment. Understanding of complex scheduling needs of our patients in an empathetic, compassionate manner is critical. Position is required to use eligibility application to invoke request to verify insurance eligibility, interpret response and capture appropriate health insurance information as it pertains to the service being rendered. The position requires ability to understand and apply contractual benefits to the service being rendered, with ability to collect patient financial obligation pre-services. The Pre-Service Representative I, after one year in the position and based on performance and success in position, has ability to be promoted to Pre-Service Representative II as Career Ladder requirements indicate. Responsibilities: * Maintain strict adherence to the Albany Medical Center Confidentiality policy. * Incorporate Albany Medical Center Customer Service Standards and demonstrates commitment toward meeting and exceeding the needs of our customers into daily activities. * Comply with all Albany Medical Center Policies. * Comply with behavioral expectations of the department. * Maintain courteous and effective interactions with colleagues. * Demonstrate an understanding of the job description, performance expectations, and competency assessment. * Participate in departmental and/or interdepartmental quality improvement activities. * Participate in the training and onboarding of new staff members * Participate in and successfully completes Mandatory Education. * Perform all other duties as needed or directed to meet the needs of the department. * Adheres to AMC Corporate Compliance Plan Qualifications: * High School Diploma * 1 - 2 years winning customer service personality with ability to engage patients and customers via telephone with superior patient experience. * Insurance knowledge, preferred 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.

Department/Unit: Patient Engagement Center Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64Salary Range: $19.00 - $24.79 The Patient Engagement Liaison is the FIRST contact to Albany Med via telephone, thus first touchpoint in our Patient's Experience. This first impression must be received in a Compassionate and Respectful manner; engaging the caller in a professional manner. The critical role of the Patient Engagement Liaison is to ensure our patients and provider requests for services are triaged expeditiously and accurately to need. Additionally, receive information from patients and providers, via telephone and fax, and review and assess how to manage the incoming information. The position requires high degree of concentration, information retention, high volume workflow and quick turnaround time of telephone call and fax information. Responsibilities: Ability to handle high volume workload and stressful environment Strong ability to multi-task and prioritize workload Ability to engage patients/customers in a calm, respectful manner; regardless of tone or attitude of patient/customer via telephone Demonstrated attention to detail with minimal error 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.

Department/Unit: Patient Engagement Center Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64Pre-Service Rep I Essential Duties and Responsibilities Responsible for registration and scheduling process for complex patients. Responsible for updating the system with registration, scheduling and insurance information. Prepares patient disability and out of work / school paperwork. Responsible for discussing financial obligation and explaining regulatory forms, as well as answering any questions. Works in multiple systems during patient facing interactions and telephone call receipts to complete accurate registration and to support the clinical workflow. Understands the practice and hospital strategic plan. Supports plans, policy and procedures, and initiatives within scope of their departments expectations and role. Represents AMC and supports the ideals and principles of their department, the Practice, the Hospital and the Center. Exemplify Albany Med CARES guiding principles. Is a champion to ensure an optimal patient experience. Understands and promotes patient and employee safety as our top priority. Promotes a safe environment and promptly reports issues. Understands patient safety goals. Qualifications High School Diploma/G.E.D. - required 2-3 years office experience or one year of related experience in a medical practice - preferred Experience using an electronic health record and Microsoft Office a plus. Excellent customer service skills. Ability to multi-task in a high patient volume unit. Ability to learn and utilize resources. Strong time management skills. Ability to review information and draw appropriate conclusions. Good judgement and ability to problem solve; escalate issues as needed. Strong teamwork skills and work ethic. 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.

Department/Unit: Patient Engagement Center Work Shift: Day (United States of America) Salary Range: $40,495.10 - $52,643.64The Pre-Service Representative I is Responsible for coordinating and scheduling radiology imaging services across multiple modalities, including MRI, CT, Ultrasound, X-ray, and Interventional Radiology, ensuring appointments are scheduled accurately based on clinical indications, provider orders, and modality-specific requirements. Reviews referrals for completeness, verifies patient eligibility, screening criteria, and exam protocols, and collaborates with clinical teams to resolve scheduling barriers. Provides clear patient communication regarding preparation, timing, and expectations to support optimal workflow, patient safety, and access to care. Education: HS Graduate Licensure, Certification & Registration: None Experience: 1 - 2 years Winning customer service personality with ability to engage patients and customers via telephone with superior patient experience. Insurance knowledge, preferred Skills, Knowledge & Abilities: Proven customer service skill with ability to exceed expectations Ability to multi-task in stressful and high patient volume unit Must be able to manage pressure of very tight timeframes to execute task Ability to learn in classroom, utilizing resources Ability to maintain composure under pressure Ability to review information and draw appropriate conclusion Good judgement and ability to be resourceful to problem solve; escalate issues as needed Team minded worth ethic Demonstrated ability interpret patient's insurance benefits and apply the applicable contractual obligations 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.

Department/Unit: Physicians Billing Work Shift: Day (United States of America) Salary Range: $38,937.60 - $50,618.88This position is a Medical billing position for a Physician Practice. Providing efficient and timely follow up of delinquent and denied accounts from third party payers is an essential part of this role. This position is responsible for securing revenue for services provided by Physicians of Albany Med by completing appeals, phone calls, and account review. Qualifications: High school diploma or GED is required. AAS degree is preferred. Customer service experience required Experience providing phone-based customer service a plus Proficiency in office software including Excel and Word Proficiency utilizing payer websites Ability to work in a team environment Ability to communicate effectively, both verbally and in writing Ability to Multi-task and handle a fast-paced work environment Demonstrate organizational and interpersonal skills Essential Duties and Responsibilities: Reviews charges and data for accuracy and appeals discrepancies in regards to CPT-4 and ICD-10 codes with Insurance Companies Validate and Correct registration and insurance information, notations, correct claim submission Researches and interprets information to efficiently reconcile accounts Review and understand payer policy guidelines regarding billing Follow internal policies and procedures for accurate account review Meet expected production and quality standards Other related duties as assigned Extensive on the job training is provided for this role to ensure knowledge and skills are sufficient to perform required duties and responsibilities. Hours for this position will be Monday through Friday, days 8:00 am-4:30 pm. 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.

Department/Unit: Patient Access Work Shift: Day (United States of America) Salary Range: $41,136.28 - $57,590.79 The Insurance Discovery and Insurance Cost Estimate Representative, AMHS has skill set encompassing strong working knowledge of third-party payer regulations; interpretation of payer contracts and applying contractual agreement to ensure payment and accurate estimates. Ability to be the liaison for challenging encounters requiring more than average time to resolve, to permit staff to manage workload. Work collaboratively with the Enrollment Service partner to ensure timely disposition for Medicaid Pending encounters. Essential Duties and Responsibilities * Review all self-pay encounters to identify insurance or determine referral to Enrollment Service Partner * Assess challenging encounters from Out of State, International to secure payment source * Provide accurate estimates in support of the No Surprise Act, Good Faith Estimates guidelines and Financial Aid Policy. * Ability to provide explanation to patients of insurance benefits and self-pay estimates, including collection of balances owed. * Ability to review, assess and reconcile Medicaid Pending inventory to ensure timely disposition. * Review and determine, based on eligibility response, benefits and coverage to ensure 100% coverage for inpatient and outpatient services. * Ability to explain to Clinic Staff, Outside Providers, and Patients financial responsibility and associated policies and legislation supporting patient's financial responsibility and expected payment guidelines. * Supports department operations as needed to ensure all encounters are financially secured prior to discharge. * Support colleagues across the Albany Med Health System to ensure workload expectations are met as a team and not as individual contributors. * Contributes to the creation of a compassionate and caring environment for patients, families and colleagues through displays of kindness and active listening. Recognizes and appreciates that each employee's work is valuable and contributes to the success of the Mission. Qualifications * Associate's Degree - required * Bachelor's Degree - preferred * 3 - 5 years working knowledge of third-party payer regulations; healthcare financial counseling and Hospital or Physician office experience; in lieu of degree 5 - 7 years experience - required * Exceptional knowledge of insurance discovery strategies including payer portals. * Knowledge of Hospital Financial Law specific to No Surprise Act and Good Faith Estimate legislation. * Demonstrated critical thinking skill to successful resolution * Proven customer service skill with ability to exceed expectations with sensitive patient interactions * Analyze encounter history to secure financial responsibility. * Ability to multi-task in stressful and high patient volume unit; must be able to manage pressure of very tight timeframes to execute task * Ability to remain composed under pressure * Ability to review information and draw appropriate conclusion * Good judgement and ability to be resourceful to problem solve; escalate issues as needed * Team minded worth ethic * Demonstrated ability interpret patient's insurance benefits and apply the applicable contractual obligations * Critical thinking ability regarding issues with financially securing payment * Ability to discuss sensitive concepts with patients regarding financial obligations * Ability to understand complex billing processes * Medical Terminology * CHAA - Certified Healthcare Access Associate within 1 Year - required Equivalent combination of relevant education and experience may be substituted as appropriate. Physical Demands * Standing - Occasionally * Walking - Occasionally * Sitting - Frequently * Feeling - Occasionally * Talking - Frequently * Hearing - Frequently * Repetitive Motions - Frequently * Eye/Hand/Foot Coordination - Rarely Thank you for your interest in Albany Medical Center! Albany Medical Center 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 Medical Center policies and standards, shall be made to ensure that information is adequately protected from unauthorized access and modification. 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.