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The Collections Analyst will be responsible for the analytics management of third party rejections of A/R, compliance analysis initiatives, and charge capture status reporting. Duties and activities will be performed in a fast paced 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. Acts as the customer service agent between third party payors/CBO/CUP internal departments. Capable monitoring, tracking and documenting reimbursement trending per relationship to rejection status. 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 compliance actions.
Capable of retrieving data and reviewing data sets that are relevant to but not limited to CPT-codes, IDC-9 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 monitoring reportable trends. Expedites efficient and effective internal and external department written and oral reporting with guided communications to designated departmental representatives. Must focus on clear department reporting, recommendations and throughput management. Interfaces well with all levels of staff and management. Maintains all PHI in accordance with HIPPA, JACHO, 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 escalation to management team as deemed necessary.
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 denial management and fee schedule reimbursement monitors. Experience should also extend but not limit to CPT Codes, IDC-9 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 junctions.
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.
High School Diploma or Equivalent (required).
Certification in medical billing and/or AAPC-AHIMA coding certification is (preferred).
Some college with knowledge of IDX billing system and EPIC-HIM system.