"Financial or Bus Analyst Sr"

The Charge Integrity Business Analyst Sr is a highly analytical and technical position that relies on revenue cycle experience to support the objectives of the Charge Integrity Unit. This position is responsible for a wide variety of charge related functionality and intradepartmental support. The successful candidate will have experience in organizational analysis, system and workflow process mapping and testing, report development, problem solving, communication and organizational skills. The position requires flexibility in taking on new work assignments and ability to work effectively as part of a team.

The Charge Integrity Business analyst Sr is expected to work closely and promote an atmosphere of teamwork with other members of Charge Integrity as well as their peers in Revenue Cycle, to achieve department objectives and provide stellar customer service. The Analyst will function in the role of a consultant to Providers, Nursing, Clinical Department Management, HITS MiChart teams, Finance, and Revenue Cycle leadership and peers (Billing, Coding, HIM, Reimbursement Specialists, Compliance, Patience Business Services, Provider Enrollment, Audit/Appeals, Revenue Analytics, LPI).

• Assist Charge Integrity Analysts with questions, troubleshooting and testing.
• Investigate charge capture issues, perform root cause analyses, analyze impact, evaluate risk factors, define pros/cons, and prepare presentations proposing and justifying build and workflow changes.
• Work with Providers, Nursing, Clinical Department Management, HITS MiChart teams, Finance, and Revenue Cycle leadership and peers to oversee/execute the design, build, testing, training, and implementation of rule or workflow changes and optimizations.
• Monitor implementations and evaluate outcomes to ensure the changes improve performance and result in optimal and compliant charge capture.
• Assist in identify areas of missed or inappropriate facility and professional revenue using billing, financial data and/or through process review of clinical, charge capture and/or billing operations
• Assist with rule creation and WQ changes, including test script creation and execution to ensure proper rule functionality.
• As assigned, work to investigate WQ backlog, identify issues, determine root causes, propose options to resolve issues, and work with others as needed to implement solutions.
• When necessary, work with Clarity report writers to design reports not available through Reporting Workbench or Tableau.
• Obtain and maintain Coding Certification. Remain current on Payer specific regulations including subscribing to newsletters, reading articles/memos and attend seminars.
• Maintain Revenue Guardian and ensure checks remain current and accurate.
• Assist with MiChart Upgrade testing and monitor post go live.
• Other projects as assigned

Required Qualifications

• Bachelor's degree in Business or Health Administration, Nursing or equivalent combination of education and work experience.
• Coding Certification- CPC, CPC-H or coding experience with certification obtained with first 12 months of employment.
• A minimum of five years' experience in the healthcare field, facility coding process and/or reimbursements, including familiarity with the functions and compliance concerns related to chargemaster required.
• Charge Integrity, Hospital PBS, Billing or Coding experience within the last 5 years from posting date.
• Strong quantitative, analytical and organizational skills. Self-starter and detail oriented. Excellent communication and written skills required.
• Experience with Microsoft Outlook, Excel, Word, PowerPoint, Epic EHR (MiChart). Experience performing financial and billing data reviews, claim and medical record reviews, analyzing documentation, identifying areas of financial risk and potential.
• Strong emphasis on Excel skillset and analytical abilities.
• Experience interpreting and applying CMS and other third-party payer guidelines and regulations.
• Strong customer service focus with the ability to articulate both written and verbal communication(s).
• Great attendance record.

Preferred Qualifications

• Knowledge of University Health System policies, procedures and regulations.
• Knowledge of or experience in the delivery of patient care
• Proficiency in Microsoft, Access, Visio, Toad DataPoint/Hyperion IR, Datamart.
• Familiarity with Payor Websites