Lead Financial Analyst

Jamison Professional Services, Inc. ( Jamison ) is currently seeking a qualified and motivated candidate for the position of Lead Financial Analyst.

JOB TITLE : Lead Financial Analyst - Bethesda, MD

DUTIES & RESPONSIBILITIES :

This position shall provide the following services :

• Responsible for determining the highest possible benefit payable to the Military Treatment Facility
• Lead Financial Analyst will lead other members of Uniform Business Office as they perform their mission of accurately collecting third party payments
• Develop additional documents as required to ensure maximum amount recoverable under the policy.
• Write justifications or special determinations related to payments received, i.e. explain why full amount billed was not paid, why the amount paid is to be written off, why money must be returned to the insurance company, etc.
• Responsible for classifying accounting transactions in automated systems, symbolic codes are used extensively.
• Provides input to the UBO Manager for analytical and evaluative methods to improve the processes of the TPCP.
• Refer serious complaints lacking resolution to higher level supervision.
• Explains and answer questions regarding the inpatient and outpatient Third Party Collection Program to patients and their insurance companies, to include entitlements, billing procedures and benefits.
• Assigns and explains work to subordinate employees.
• Coordinates meeting deadlines, providing a continuous smooth flow of work through the office and expedites process of priority cases.
• Reviews work for completeness, accuracy, and compliance with regulatory requirements.
• Audits work daily performed appropriate International Classification of Diseases (ICD-10) and Current Procedural Terminology (CPT-4) codes, clinical rate;

payments posted to accounts and denied or reduced payment compliance guidelines.

• Submit inpatient and outpatient claims, reviewing inpatient and outpatient claims, making follow up calls as necessary.
• Post accounting transaction for payments received from the Insurance Companies to appropriate computerized ledgers and subsidiary records.

Verify amounts received against amounts billed.

• Closed the amount when less than received amount is deemed correct, or re-bill the third-party payer for the difference.
• Contact the insurance company or its designated reviewing organization to obtain pre-certification approval prior to admission or same day surgical procedure.
• Collect, organize, and prioritize data, files and claims in a timely manner. File claims appropriately stamping correct codes on inpatient and outpatient claims
• Prepare denial request letters based on inability to provide itemized bill statement.
• Run reports weekly from ABACUS to identify errors and call vendors to correct such errors.
• Train new employees on the billing system Armed Forces Billing and Collection Utilization Solution (ABACUS) Print UB-04 and CMS 1500 forms three times a week and distribute to the appropriate Billers.
• Answer telephone inquiries from within WRNMMC regarding patient status, admissions dispositions, length of convalescence and transfer status.
• Retrieves medical records and other data for research projects and for diagnostic, training, or review purpose.
• Coordinate the performance and daily distribution of identification and collection of Other Health Insurance (OHI) patient information for all billable clinics that support the Uniform Business Office (UBO) revenue generation for WRNMMC.
• Provide recommendations on Third Party Collection Program (TPC), Uniform Business Office (UBO) compliance that follow medical documentation and billing rules and standards.
• May communicate with administrative coordinators throughout the hospital on Outpatient Itemized Billing (OIB) procedures to ensure that optimal reimbursement is attained for their respective.
• Train clinics personnel on the proper procedure use of the DD-2569 forms.
• Educating and training others (patients' clinical staff members, managers) on the importance of the OHI (Other Health Insurance) Program regarding the Patient's DD2569 Form.
• Train others in utilizing the installed clinic scanners (which scan the patients' insurance card).
• Aggressively follow-up with third party payers on billed claims that are more than 30, 60, 90 and 120 days or more to ensure payment is received from insurance carriers on claims in a timely manner.
• Reconciling accounts accurately in a timely manner in ABACUS / General Ledger according to the UBO Guidelines and the patients' specific health benefits policy.
• Cross train other staff members in the different functions related to the Financial Technician Position.
• Provide an average of 12,000 financial management support actions annually. It is estimated that one skilled employee can complete approximately 3 actions per hour.

QUALIFICATIONS :

Must have a minimum of 2 3 years’ experience with standard office financial and administrative functions with excellent verbal and writing skills.

Must have a High School Diploma, or associate degree or higher

Basic knowledge of medical terminology. Knowledge of the hospital computer system (CHCS) and ABACUS (Gov. will train).

Working knowledge of Microsoft Office.

• Ability to use general office equipment including telephone, fax, copier, etc. Customer service expertise.
• Ability to use automated systems effectively
• Post accounting transaction for payments received from the Insurance Companies to appropriate computerized ledgers and subsidiary records.
• Detailed intensive knowledge of policies, precedents, goals, objectives, regulations, and guidelines of a functional area.
• Ability to lead supervise and motivate employees

PRIMARY PLACE OF PERFORMANCE :

Walter Reed National Military Medical Center

Bethesda, Maryland.

ANTICIPATED DUTY HOURS :

Monday - Friday 0600 - 1600 with a 1- hour unpaid lunch.

JAMISON CORPORATE OVERVIEW :

Jamison Professional Services, Inc. (Jamison) is a Service-Disabled, Veteran-Owned Small Business (SDVOSB), certified Minority Business Enterprise (MBE) headquartered in metropolitan Atlanta, Georgia.

We specialize in providing professional management, administrative, healthcare, court reporters and transcriptionist experts, and document / record and telehealth operational support solutions to U.

S. Government, State, and commercial clients. Jamison is a nationwide professional staff augmentation company, that helps commercial clients and government agencies expand their talent acquisition reach by sourcing, assessing, developing, and managing the talent that enables them to be successful.

Jamison offers a wide range of employment opportunities in the commercial and government sectors. We seek employees who share our values of service excellence, integrity, and professionalism.

Jamison affords equal employment opportunity to all individuals, regardless of race, creed, color, religion, gender, national origin, ancestry, age, marital status, veteran status, disability, medical condition, gender identity, or sexual orientation.

Our employees, as well as applicants and others with whom we do business, will not be subjected to sexual, racial, religious, ethnic, or any other form of unlawful harassment and / or discrimination.

In addition, Jamison adheres to the equal employment opportunity requirements of all states and localities in which it does business.

Jamison’s commitment to equal opportunity is applied through every aspect of the employment relationship, including, but not limited to, recruitment, selection, placement, training, compensation, promotion, transfer, termination, and all other matters of employment.