Application Specialist

Applications Specialist

The Applications Specialist is responsible for encounter correction, auditing and compliance of hospital billing as it pertains to the Patient Access Department. The Applications Specialist must have critical thinking skills with aptitude for encounter error correction per local, state and federal billing guidelines. Auditing of Patient Access processes to ensure efficiency, accuracy and compliance as outlined in policy and procedure provides a check and balance of patient access functions. The Applications Specialist must be able to review encounters from point of registration to payment or denial; identify issues to accurately correct encounter. Must be able to understand Hospital Based Clinic management to ensure compliance with regulatory requirements. Must be able to manage significant workload and assist where and as needed throughout Patient Access.

Required Qualifications:

• Associates degree
• CHAA (or acquired within 2 years of hire)
• Strong computer skills
• 35 years' experience
• Hospital Revenue Cycle or Patient Access experience
• Strong insurance knowledge regarding payer contract interpretation including Authorization Requirements and Setting of Care

• Proficient skills with EXCEL and ACCESS
• Proven analytical, trending and recommendation for improvement
• 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
• Strong understanding of information technology integration
• Strong understanding of ADT system; encounter correction
• 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 work ethic
• Demonstrated ability to interpret patient's insurance benefits and apply the applicable contractual obligations
• Strong understanding of hospital billing regulations

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.