AAPC or AHIMA certification required; certification must be obtained within 12 months of hire (CPC, RHIT, RHIA, or combination)
High School diploma required; Bachelor's degree preferred
5-7 years of hospital billing operations experience
3 years of coding experience
Strong knowledge of Medicare, Medicaid, and managed care billing regulations
Experience with healthcare systems such as EPIC, IDX, OACIS, or Last Word
Advanced Excel and PC-based reporting skills
Responsibilities
Lead perioperative and procedural billing operations to ensure accurate revenue capture
Review system-generated charge reports to correct and complete data promptly
Collaborate with Revenue Cycle to maintain departmental work queues for timely billing
Develop and educate staff on billing policies, procedures, and regulations
Support workflow improvements to enhance charge capture accuracy
Communicate updates on coding and billing policies to staff
Partner with Supply Chain to establish new product records and billing code assignments
Benefits
Remote work opportunity with a day shift schedule, Monday to Friday
Full-time position with a focus on work-life balance
Opportunity to mentor and develop staff in a collaborative environment
Engagement with multiple departments to enhance operational efficiency
Potential for professional growth in a complex academic medical center setting
Full Job Description
Job Description
The Senior Billing Analyst leads perioperative and procedural billing operations to ensure accurate, compliant, and timely revenue capture. Reporting to the Assistant Director of Business Operations, this role partners with Revenue Cycle, Supply Chain, Nursing, and Perioperative Leadership to reconcile supply and facility charges, assign CPT/ICD/HCPCS codes, audit documentation, and oversee departmental work queues. The Senior Billing Analyst plays a critical role in safeguarding revenue integrity, improving charge capture workflows, and mentoring staff to meet regulatory and operational standards.
Essential Functions:
Reviews system-generated charge reports to identify, correct, and complete inaccurate or missing data in a timely manner; assigns CPT, ICD, and HCPCS codes and enters charges as needed to meet a 3-day billing target.
Ensures all supply and facility charges are accurately posted within three (3) days of the date of service (or discharge date, if applicable).
Collaborates with Revenue Cycle to reconcile and maintain departmental work queues, ensuring timely and compliant billing.
Develops, educates, and orients staff on departmental policies, procedures, and billing regulations, including LMRPs, APCs, diagnosis coding, and documentation requirements.
Supports the design and implementation of workflow improvements to enhance charge capture accuracy and reduce revenue leakage.
Communicates updates regarding coding and billing policies and procedures; interprets regulatory changes and provides guidance to staff as needed.
Partners with Supply Chain to establish new product records and confirm accurate account and billing code assignments.
Assists in the investigation and resolution of charge-related disputes.
Performs additional duties related to revenue capture, reimbursement, and departmental operations as assigned.
Licensure/Certification:
AAPC or AHIMA certification required.
Certification required within 12 months of hire (CPC, RHIT, RHIA, or combination)
Required Qualifications:
High School diploma (Bachelor's degree preferred)
5-7 years of hospital billing operations experience
3 years of coding experience
Reviewing and applying CCI edits
Strong knowledge of Medicare, Medicaid, and managed care billing regulations
Working expertise in CPT and ICD coding systems
Certification required within 12 months of hire (CPC, RHIT, RHIA, or combination)
Completion of medical terminology coursework
Experience with healthcare systems such as EPIC, IDX, OACIS, or Last Word
Advanced Excel and PC-based reporting skills
Strong analytical, organizational, and communication skills
Preferred Qualifications:
GI Operating room billing experience
Experience in a complex academic medical center environment
Position Details:
Job Type/FTE: Full-time
Shift: Remote Day shift, M-F
Unit/Department: CCD
CBA Code: Non-Union
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