Senior Business Analyst PB Revenue Integrity - Remote
- Owensboro, KY
- $71,200-127,200 per year
- Permanent
- Full-time
- Operational/Procedural Responsibilities
- Serves as an internal resource to clinical departments around professional charge capture and professional charge master updates
- Works with the revenue producing departments to ensure the ongoing coordinated consistency of the Chargemaster, including accurate descriptions, coding, additions, deletions, pricing and any other changes
- Monitors revenue compliance with clinical departments, evaluating professional charge capture processes for new and existing services, implementing best practices
- Participates in ongoing coordination and resolution of revenue issues as they arise ensuring the overall integrity of the charge capture process
- Monitors professional charging mechanisms and systems with in-depth knowledge of how orders and charges are entered and of the various system workflows to ensure proper generation of charges for billing
- Analyzes reports to determine areas of improvement and determine appropriate plan of action by reviewing data and systems to target areas of improvement
- Maintain a timely turnaround of all requests.
- Maintain high productivity and quality with minimal supervision
- Yearly continuing education is required
- Ability to multi-task and work under aggressive deadlines
- Possess effective time management skills to permit handling of a large workload
- Financial Responsibilities
- Performs analysis
- Ability to understand and analyze payer regulations and impact to the Professional Chargemaster on reimbursement and coding guidelines
- Disseminates CMS updates to health care providers and clinical departments as they relate to billing, ensuring the necessary changes are implemented.
- conducts internal reviews to improve revenue cycle, claims production and coding integrity
- Monitors compliance with corporate, federal, and state guidelines bringing forward changes, as applicable, while focusing on accuracy and revenue cycle integrity
- Maintains a solid working knowledge of the revenue cycle process to aid in the implementation of regulatory standards assuring appropriate and timely cash collection
- Troubleshoot and resolve issues related to the revenue cycle by developing, presenting and implementing recommendations
- Responsibilities for Relationships
- Develop and maintain solid working relationships with internal and external customers
- Collaborate with managerial and supervisory staff to ensure compliant regulatory billing with correct coding on accounts
- Performs similar or related duties as requested or directed
- Performs other duties as requested and observed by supervisor or manager
- 5+ years of relevant experience e.g. patient billing and revenue cycle experience, experience in finance within a healthcare organization
- 5+ years of experience CPT/HCPCS, UB-04 Revenue Coding, modifiers, billing regulations APC's, APG's and DRG's
- 3+ years of experience with Epic
- Proficient in the use of Microsoft Office Programs, including but not limited to Excel, Word, and Access
- 5+ years of revenue cycle processes within a healthcare organization
- 5+ years of financial related work experience
- 5+ years of experience with CMS coding and compliance rules
- 5+ clinical settings such as Laboratory, Radiology, Physical or Occupational Therapy, Respiratory Therapy, Cardiology, or Oncology
- Solid professional billing knowledge
- Demonstrated familiarity with Epic - resolute and clinical apps
- Demonstrated ability to organize and assess various statistical and financial data and put forth conclusions based on data collected.
- Demonstrated ability to accomplish a defined scope of job performance through independent investigation, self-motivation, analytical and problem- solving techniques