Billing Analyst
Summary
Processes and reconciles monthly billing data for a healthcare specialty pharmacy, ensuring accuracy and compliance with contracts while supporting digital transformation projects.
JOB SUMMARY
The Billing Analyst, under the direction of the Senior Manager, Program Billing and Analytics, completes monthly billing, reconciliation, data management and verification activities as required by Bayshore Specialty Rx. Maintaining data integrity while preparing and analyzing all billing data in accordance with contractual obligations.
DUTIES AND RESPONSIBILITIES
• Acquire data from primary or secondary data sources and maintain databases/data systems
• Identify, analyze and interpret trends or patterns in complex data sets
• Participation in various Billing digitalization and transformation projects including but not limited to automation, reconciliation, validation, and analytics of Bayshore Patient Support Services.
• Prepare supporting data to invoices, reconciling production data to invoice to ensure completeness;
• Generate and submit supporting back-up to Reviewers/Approvers and make revisions as required;
• Analyze and understand all billing calculations to ensure billing is consistent with contractual terms, escalate billing issues and or concerns to the Validation and Reconciliation Manager.;
• Develop and document efficient billing data procedures for new and existing business needs as determined by Management;
• Additional duties include reconciliation of billing data, data entry, filing, and obtaining/organizing supporting documentation including preparation of reports, spreadsheets and dashboards as needed; ensuring monthly timelines and targets are met
• Ensure deadlines are met for all reporting commitments
• Auditing of controls and Invoices of program Billing and Co-pay data in accordance with contractual obligations and thresholds.
• Review, validate and reconciliation of month end invoice back up data before its sent to the billing department.
• Participates in proactive Health & Safety activities while performing all duties. Is responsible to notify immediate Supervisor of any health and safety risks or concerns. Responsible for completing Accident Reports for all direct reports who injure themselves on the job, within 24 hours of the incident.
• Maintains confidentiality of client and corporate information and discusses same only with appropriate Bayshore personnel
• AAd- Hock requests from Senior Management