Denial Prevention Analyst II
Summary: This position is responsible for conducting financial analytics into a patient's overall financial responsibility as it relates to upcoming care within the Steward Healthcare System. Analysis will leverage the interpretation of payor contracts as well as state and federal regulatory guidelines to maximize revenue realization. These efforts will result in increased net revenues by reducing bad debt from potential write-offs due to lack of patient collections and denials. Interactions will primarily be conducted with patients and results of efforts will drive actions to secure payment for scheduled patients.
Responsibilities: knowledge of health insurance and reimbursement/billing required. Ability to comprehend payor responses (EDI), e.g. 271/272 transactions ; Excellent customer service skills. Excellent communication skills (verbal and written). Analytical skills, e.g. competent math skills (see below) ; Basic knowledge of healthcare finance. Conflict resolution Promotes quality and demonstrates accuracy and thoroughness. Competent utilizing Microsoft office, e.g. Excel, PowerPoint, and Word (see below). Familiarity and experience with Revenue cycle software, tools, and technologies. Medical Terminology and working knowledge of Coding knowledge required. Time management and flexibility to meet work schedule demands. Good judgment and problem solving skills (escalation process). Ability to work independently and take initiative. Ability to work with a high degree of confidentiality. The ability to manage multiple tasks simultaneously and adjust to issues as needed in a dynamic work environment. Proven ability and/or expressed willingness to work as part of a team. Privacy, Safety and Security- the individual observes privacy, safety and security procedures and uses equipment and materials properly.
Qualifications: 1-2 years experience in dynamic healthcare (clinic, physician, or hospital setting) or payor environment performing activities such as patient collections, registration and/or scheduling. Certified Healthcare Access Associate (CHAA) a plus. Comfort with data entry within Revenue Cycle software, patient management systems and Windows based applications preferred. Competent utilizing Microsoft Office (Excel, Word) is a plus.Basic understanding of Revenue Cycle functions, flow, and operations strongly preferred. Competent in core math skills required ( determined by obtaining satisfactory score on competency exam). Associates degree required, Bachelor's Degree (BA or BS) with emphasis in Business Administration and/or Healthcare, preferred. Experience level will also be a factor in lieu of educational requirements.