*All positions are located in Fresno/Clovis CA*
We're looking for a Staff Analyst to join our Financial Services team! In your role, you will be essential for the analysis of clinical and technical denials, as well as payment collection of outstanding accounts receivable. We are looking for a detail-oriented team member with advanced expertise in accurately analyzing documents/cases - ensuring proper denial and payment review. From Performs root cause analysis, to extrapolating results across a wide range of denials, to accurately reporting recommendations for improvement, you will work to assure compliance with official guidelines and policies.
The Community Health System is a locally owned, not-for-profit, public-benefit organization based in Fresno, California. Community is the region's largest healthcare provider and private employer. We operate a physician residency program with one of the nation's top medical schools – the University of California, San Francisco.
We are home to the only Level 1 Trauma Center and comprehensive burn center between Los Angeles and Sacramento and also serve as the area's \"safety net provider.\" In fiscal year 2020, Community provided nearly $175 million in uncompensated services and programs.
Because we know our ability to provide the highest level of care begins with our incredible staff, we provide excellent benefits. On top of competitive pay, hearty retirement plans, and other core benefits, we provide extras like free concierge services to run your errands while you work, on-demand well-being, a free employee gym with free personal training, and more.
Your Career at Community | Opportunity. Challenge. Growth.
Responsibilities:
In your role, you will:
Conduct analysis of assigned accounts and research denials to identify root causes and short/long term solutions.Evaluate, track, and formulate accurate reports. Documents findings based on established guidelines. Effectively communicate results and provide meaningful recommendations.Submit documentation and/or appeals as appropriate, and ensure payments received are in accordance with contract terms and reconciled correctly. Meet quality and productivity expectations, and demonstrate strong organizational skills.Work with cross departmental staff, vendors, and payers to research and understand specific reasons for denials and conveys preventable measures to prohibit future denials.Perform follow-up actions to include, but not limited to – telephone call, claim inquiry via payer website, or Provider Relations contact. Maintain active follow-up within established guidelines until full resolution is achieved.Qualifications:Education
High School Diploma, High School Equivalency (HSE) or Completion of a CHS Approved Individualized Education Plan (IEP) Certificate required
Experience
5 years of healthcare business office, billing, financial services or related experience requiredHospital billing experience preferred
Click HERE to learn more about our awesome benefits offerings as well!
Disclaimer:
• Pay ranges listed are an estimate and subject to change.
• If any bonuses are noted, they are only applicable to external hires meeting criteria.