Job Description

Essential Duties and Responsibilities include the following. Other duties may be assigned: 

Identify trends in underpayment/overpayments, denials, revenue opportunities and revenue leakageEvaluate trends and works towards resolution and improvement of revenue cycle processesInterpret contract reimbursement and provide feedback to management staff as requiredManage underpayment appeals, account follow-up and payer relationshipsCompile and analyze data to make recommendationsWork with financial and clinical departments collaborativelyReview contract validation, updates and interpretationResolve underpaid claims in an effective and timely fashionReview payer policies for impact on reimbursementPresent data to various end usersCompile and validate account analysis prior to distributionResearch and identify payment discrepancies from various sourcesOther duties as assigned

Qualifications:

To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Highly organizedInitiative to work independentlyProficient with telephone and email communicationsBasic understanding of medical coding systems affecting the adjudication of patient accounts in EDI or UB04 form,      

      including:  ICD-9, CPT, HCPCS, DRG, APG, APC, and revenue code structures

 Reasoning Ability:

The analyst must have the ability to define problems collects data, establish facts, and draw valid conclusions. The analyst must have the ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.

 Computer Skills:

To perform this job successfully, an individual should have:

Interest and aptitude in computer-based applications for complex business processes involving Boolean expressions,

       symbolic representation and procedural logic

Required PC competencies including intermediate Microsoft Office skills

Physical Demands:

The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

 Education/Experience/Skills:

High School graduate or equivalentMinimum of 1 (one) year of hospital revenue cycle experience or equivalent work experienceExcellent interpersonal skills required to communicate with direct staff and internal/external customersMust possess excellent time management and organizational skills with great attention to detailMaintain applicable continuing education requirementsThe ability to work on multiple projects/initiatives at a time

 

INDSS