Analyst-reimbursement
SCHEDULE : 40 hour work week, primarily Monday through Friday, 8am - 4 : 30pm Excellence, Teamwork, Leadership and Innovation.
independently performing a full range of tasks in reimbursement analysis including development of procedures to ensure recovery of all inpatient and outpatient charges, contract management, external financial reporting, revenue capture, accounts receivable analysis and regulatory compliance monitoring.
SUPERVISION RECEIVED : Works under the general supervision of an employee of higher grade. SUPERVISION EXERCISED : May lead staff as assigned.
- EXAMPLES OF DUTIES : Develops techniques for effective analyses of reimbursement trends; reviews, analyzes and interprets insurance payments and denials to ensure proper payment;
- works with billing supervisors to modify billings to meet contract specifics, as well as charge-master analyst; recommends updates to charge master;
- develops and maintains system for tracking and evaluating performance of insurance carrier to maximize reimbursement and ensure billing compliance with audit standards;
- provides reimbursement patterns and trends to the management; prepares reports and analyses to include financial reports, setting forth progress, adverse trends and appropriate recommendations and conclusions;
- submits external reports and handles all edits and changes required by meeting with appropriate departments to obtain correct data;
- monitors and evaluates current reimbursement rules and changes that impact revenue capture and communicates this information to the clinical faculty, staff, and billing personnel;
- provides in-service training for finance personnel; develops and recommends policies and procedures; schedules assigns, oversees and review work of assigned staff;
- applies personnel policies and procedures; prepares or assist in the preparation of the department budget subject to administrative review;
- acts as liaison with other operating units, agencies and outside officials regarding third party reimbursements; may assist in the preparation of profit and loss statements;
performs other related duties
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