Under general supervision by the department’s Supervisor and Manager of Financial Data Analytics, this position is responsible for the accuracy and integrity of the revenue received to all sites at AHS. This position also provides communication regarding the quality monitoring of payments from payors, maintenance issues, along with providing education to team members, training, and follow-up to necessary payors for proper reimbursement.

Principal Accountabilities:

 

Effectively analyzing Organizational AR to ensure proper and prompt reimbursement.  Analyze hospital claim data to identify contractual underpayments and billing errors.  Pursue underpayments with insurance provider representatives via monthly teleconference to effectively resolve complicated accounts where AHS is not in agreement with how the carriers processed the accounts. Provide management monthly payor reports to identify trending contractual issues. Compile queries and complex data sets to analyze payor reimbursement using Epic reporting tools. Maintain Payor Trend Analyst and Valid Payor Issue WQ’s housing trending issues and specific underpaid claims to be reviewed. Provide workbench reports as requested by management for reimbursement of specific services. Identify areas of needed improvement using the Director Detailed Dashboard to improve AR days and cash flow. Acts as liaison with all payors and works closely with the Managed Care team.  Communicates with necessary ISS analyst to troubleshoot system issues. Performs other duties as assigned.