The A/R Analyst will be responsible for the analytics management of third party responses of professional fee accounts receivable and denial trending metrics. Duties and activities will be performed in a fast paced professional fee central billing office environment. Duties are dedicated to accuracy, timely data mining, and analysis of any elements mapped to factors that impede on collection activities and/or reduction in accounts receivable. Acts as the data support for accounts receivable, denial management and third party payors. Capable of monitoring, tracking, and documenting accounts receivable trending in relationship to rejection status(es), no responses, and 277 response message status(es). Responsible for full comprehension of CUP revenue cycle work design mechanisms including but not limited to registration, charge capture, payment posting, account receivable follow up, accounts receivable rejections processing and credit management. Assist the management team in identifying trends, productivity barriers with the goal of process improvement.
Capable of retrieving data and reviewing data sets that are relevant to but not limited to CPT-codes, ICD-10 codes, HCPCS codes, coordination of benefits, additional documentation needs, registration denials, third party payer rules, LCDs and NCDs, compliance measures and other third party payor rejections language. Responsible for accurate review to insure data sets and data interpretation are managed in a time sensitive environment with a focus on accurate reportable trends. Expedites efficient and effective analysis to support denial management and accounts receivable management decision making. Consice oral and written communication to interpret data and reporting out for management team. Must focus on departmental reporting, and ability to monitor and measure the recommendations and throughput management of information system resolution, third party payor solutions and accounts receivable and denial management solutions. Interfaces well with all levels of staff and management. Maintains all PHI in accordance with, HIPPA, Joint Commission, third party contractual agreements along with CUH policy and procedures.
Ability to manage daily job functions along with special project work and prioritize level of importance on demand. Capable of indentifying third party payor response trending and recommend solutions to management team.
Scheduled Days / Hours: M-F
High School Diploma or Equivalent (required). Some college with knowledge of Epic PB billing system, Epic Access and Revenue Cycle and EPIC-HIM system along with certification in medical billing is (preferred).
2-4 years of professional fee accounts receivables resolution experience is (preferred).
Experience will be proficient in the understanding and management of all functions related to third party billing processes specializing in accounts receivable management and fee schedule reimbursement monitors. Experience should also extend but not limit to CPT Codes, ICD-10 coding knowledge, medical terminology, reimbursement terminology, medical record documentation, and reimbursement analysis. Experience should also include a clear understanding of third party contract language; appeals process management, credit account balance analysis, denial/rejection analysis and resolution, medical billing regulations-guidelines, payor specific rules and guidelines, and financial accounts receivable language as it relates to job functions.
Ability to manage internal departmental relationships as it relates to operational efficiencies and recommendations for corrective action along with throughput management of implementation. Excellent oral and written communication skills with strong analytical skills as well as report writing and data mining/extraction. Computer literate, comfortable with Microsoft Office software including but not limited to Excel, Word, and Outlook.