Business Analyst - Managed Care

Job Description

Additional Information About the Role Remote position! (Must live in MO or IL) Hospital Billing Managed Care knowledge. Strong understanding of managed care payors and complexity of multiple different plans under the same payor.

Experience working in hospital billing / data analysis. Experience working with Epic Cogito preferred. Required experience building excel data reports and working in SQL.

Must understand how to work with large data sets and create appropriate formulas to pull out the information needed for requests.

Experienced using AbleBits in Excel. Basic understanding of revenue management codes and where to find this information on encounters.

Understanding of payor structure, able to monitor trends, and escalate concerns as identified. Position will receive primarily adhoc requests from BJC executive leadership related to managed care billing and payments.

Overview BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St.

Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations.

Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.

9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay.

In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St.

Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

Charge Process Department is responsible for entity charge masters and revenue usage reports. Support both internal and external customers on all aspects of maintenance and reporting from the five chargemaster patient accounting systems which house nine different chargemasters within the system.

Performs financial analysis detailing gross and net revenue impacts to ensure consistent charging methodologies, market sensitivity and maximum reimbursement are coordinated.

Preferred Qualifications Role Purpose This position is primarily responsible for supporting the planning and execution of BJC-wide projects.

Responsibilities include data analysis, reporting, issue tracking / management, status reporting / management and other analysis to support healthcare regulatory and compliance requirements.

This individual will work alongside project managers in areas such as Clinical Adoption, Health Information Management, Revenue Management, Information Systems and Finance to assist in the development and execution of an integrated project across BJC Healthcare.

Responsibilities Manages complex databases and supervises report generation. Creates meaningful metrics for key system functionality, opportunities for improvement and innovation, user needs assessments, compliance, and other usage related processes.

Produces presentations, spreadsheets and other documents. Analyzes data to identify improvement opportunities and monitor changes.

Uses SQL and other analytical technology to collect and manage data to provide in-depth analysis needed to support business operations to meet operational and strategic goals.

Collects data around projects and services in area of expertise, and makes suggestions for improvement or enhancement of current services.

Researches best practices for clinical and workflow practices. Minimum Requirements Education Bachelor's Degree Experience 2-5 years Preferred Requirements Licenses & Certifications RHIA / RHIT Benefits and Legal Statement BJC Total Rewards At BJC we’re committed to providing you and your family with benefits and resources to help you manage your physical, emotional, social and financial well-being.

Comprehensive medical, dental, vison, life insurance, and legal services available first day of the month after hire date Disability insurance* paid for by BJC Pension Plan* / 403(b) Plan funded by BJC 401(k) plan with BJC match Tuition Assistance available on first day BJC Institute for Learning and Development Health Care and Dependent Care Flexible Spending Accounts Paid Time Off benefit combines vacation, sick days, holidays and personal time Adoption assistance To learn more, go to www.

bjctotalrewards.com / Benefits *Not all benefits apply to all jobs The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position.

It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

Equal Opportunity Employer Qualifications

Role Purpose This position is primarily responsible for supporting the planning and execution of BJC-wide projects. Responsibilities include data analysis, reporting, issue tracking / management, status reporting / management and other analysis to support healthcare regulatory and compliance requirements.

This individual will work alongside project managers in areas such as Clinical Adoption, Health Information Management, Revenue Management, Information Systems and Finance to assist in the development and execution of an integrated project across BJC Healthcare.

Responsibilities Manages complex databases and supervises report generation. Creates meaningful metrics for key system functionality, opportunities for improvement and innovation, user needs assessments, compliance, and other usage related processes.

Produces presentations, spreadsheets and other documents. Analyzes data to identify improvement opportunities and monitor changes.

Uses SQL and other analytical technology to collect and manage data to provide in-depth analysis needed to support business operations to meet operational and strategic goals.

Collects data around projects and services in area of expertise, and makes suggestions for improvement or enhancement of current services.

Researches best practices for clinical and workflow practices. Minimum Requirements Education Bachelor's Degree Experience 2-5 years Preferred Requirements Licenses & Certifications RHIA / RHIT

Responsibilities

BJC HealthCare is one of the largest nonprofit health care organizations in the United States, delivering services to residents primarily in the greater St.

Louis, southern Illinois and southeast Missouri regions. With net revenues of $6.3 billion and more than 30,000 employees, BJC serves patients and their families in urban, suburban and rural communities through its 14 hospitals and multiple community health locations.

Services include inpatient and outpatient care, primary care, community health and wellness, workplace health, home health, community mental health, rehabilitation, long-term care and hospice.

BJC is the largest provider of charity care, unreimbursed care and community benefits in the state of Missouri. BJC and its hospitals and health service organizations provide $785.

9 million annually in community benefit. That includes $410.6 million in charity care and other financial assistance to patients to ensure medical care regardless of their ability to pay.

In addition, BJC provides additional community benefits through commitments to research, emergency preparedness, regional health care safety net services, health literacy, community outreach and community health programs and regional economic development.

BJC’s patients have access to the latest advances in medical science and technology through a formal affiliation between Barnes-Jewish Hospital and St.

Louis Children’s Hospital with the renowned Washington University School of Medicine, which consistently ranks among the top medical schools in the country.

Charge Process Department is responsible for entity charge masters and revenue usage reports. Support both internal and external customers on all aspects of maintenance and reporting from the five chargemaster patient accounting systems which house nine different chargemasters within the system.

Performs financial analysis detailing gross and net revenue impacts to ensure consistent charging methodologies, market sensitivity and maximum reimbursement are coordinated.