Billing and Medical Record Analyst

Location

Franklin, TN | United States

Job description

SEEKING A BILLING AND MEDICAL RECORD ANALYST

Our Team:

We are improving the lives we touch. We need passionate, talented people working together who share our desire to create a world-class organization that sets the standard of excellence in the treatment of speciality behavioral health and addiction disorders.   Acadia Healthcare is headquartered in Franklin, Tennessee and is a leading provider of behavioral healthcare services in the nation. Our organization values input from employees and fosters collaboration to create a team oriented service delivery system. This position is in Franklin, Tennessee with potentail hybrid opportunities .

Our Benefits:

• Medical, dental, and vision insurance
• Acadia Healthcare 401(k) plan
• Paid vacation and sick time
• Opportunity for growth that is second to none in the industry

Your Jo b as a Billing & Medical Record Analyst :

Reporting to the Director – Compliance Auditing and Monitoring, the Medical Record Analyst serves as the subject matter expert for medical record reviews as it relates to clinical and financial components of the patient record including, medical necessity, quality documentation requirements. T he Medical Record Analyst collaborates with CTC Group Operational Leadership and CTC Business Office to assist with external reviews and/or audits from third party payors and governmental agencies. The Medical Record Analyst will trend findings from both internal and external reviews/audits to assist with standardizing best practices and training needs of the CTC Group programs.

Hours:

This position offers a hybrid schedule option.

Your Responsibilities as a Billing & Medical Record Analyst:

• Responsible for gathering, reviewing, and submitting all requested and/or required documentation to fulfill medical record requests
• Tracking and processing of medical record requests; post payment reviews from third party payors and government entities
• Communicates with third party insurance carriers/government agencies to verify medical record content requirements and timelines
• Coordinates with the clinic and CBO teams to track pre-payment reviews to identify trends/risks and report and escalate to leadership
• Collaborates with CTC Group operational and business office leadership on all payor and governmental agency requests for records
• Communicates with clinic team and operational leadership when medical record requests are received
• Assists with review of audit findings and development of audit appeals as needed
• Communicates findings to leadership and make recommendations for improvement in processes or EMR functionality based on audit findings
• Provides monthly and quarterly reports on review trends based on medical record requests and audit findings
• Maintains effective communication with third party insurance carriers to resolve issues identified during the audit process
• Maintains knowledge of industry standards and trends including CPT, ICD-10 and Medicare/Medicaid guidelines
• Provides feedback and recommendations on medical record process improvement

STANDARD EXPECTATIONS:

• Complies with organizational policies, procedures, performance improvement initiatives and maintains organizational and industry policies regarding confidentiality.
• Communicate clearly and effectively to person(s) receiving services and their family members, guests and other members of the health care team.
• Develops constructive and cooperative working relationships with others and maintains them over time.
• Encourages and builds mutual trust, respect and cooperation among team members.
• Maintains regular and predictable attendance.

Your Skills and Qualifications as a Billing and Medical Record Analyst:

• Minimum of 4 to 5 years’ experience in utilization review within an outpatient behavioral and substance abuse healthcare preferred
• Experience using Adobe, Excel and Word
• Previous experience with a proprietary healthcare system highly preferred.
• Demonstrates strong healthcare billing and coding aptitude and possesses associated technical skills.
• Strong communications skills - both written and verbal.
• Experience working with IT and proficiency with software packages including Excel.
• Ability to work professionally with sensitive, proprietary data & information while maintaining confidentiality.
• Excellent interpersonal skills including the ability to interact effectively and professionally with individuals at all levels; both internal and external.
• Exercises sound judgment in responding to inquiries; understands when to route inquiries to next level.
• Self-motivated with the ability to work independently with strong organizational skills and superior attention to detail.
• Must be able to manage multiple tasks/projects simultaneously within inflexible time frames.
• Ability to adapt to frequent priority changes.
• Capable of working within established policies, procedures and practices prescribed by the organization.
• English sufficient to provide and receive instructions/directions.

LICENSES/DESIGNATIONS/CERTIFICATIONS:

• CPC – Certified Professional Coder or CCS – Certified Coder Specialist Preferred
• RHIT – Registered Health Information Technician or RHIA – Registered Health Information Administrator Proffered

We are committed to providing equal employment opportunities to all applicants for employment regardless of an individual’s characteristics protected by applicable state, federal and local laws.

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