Financial or Bus Analyst Sr

A cover letter is required for consideration for this position and should be attached as the first page of your resume. The cover letter should address your specific interest in the position and outline skills and experience that directly relate to this position.

Under general supervision of the director, performs and oversees multiple functions to support the enterprise-wide centralized authorization and financial clearance department's adherence to payor coverage and authorization requirements. Formulate and define process scope and objectives through workflow documentation, research and fact-finding of applicable business operations, business systems and industry standards. Work with clinical departments, HITS and Revenue Cycle to develop or modify systems to accommodate moderately complex insurance processes. Identify and document any gaps with the current workflow processes and technology and make process improvement recommendations. Create and document new workflows that are patient-centered, eliminate waste and closes gaps on front end operations based on back-end knowledge and analysis. Perform testing and education related to new features and upgrades for authorizations and financial clearance. Monitor and analyze results to ensure positive outcomes.

• Develop a comprehensive, cross-functional understanding of business processes, production systems, enterprise-wide data warehouses/sources and departmental databases related to insurance authorizations
• Perform business analysis, technical evaluation, and documentation of duties for authorization and financial clearance processes.
• Work closely with clinical areas, Revenue Cycle, Coding, Contracting, CDSs, RQLs and other operational areas/roles to understand business and user needs.
• Create project plans that document business requirements, scope documents and standard operating procedures, develop testing scripts and timelines
• Stay current on authorization and surprise billing requirements as it relates to healthcare.
• Investigate and resolve issues for staff related to authorizations; analyze issues to isolate specific operational and technical problematic component(s).
• Research best practices for authorizations and financial clearance; share information and assist leadership in developing best practices.
• Identify and implement process improvements related to authorizations and financial clearance; define prioritization process for authorization project requests.
• Complete root cause analysis on authorization related denials and write-offs; prepare, analyze and present reports to track and identify trends; make recommendations for process improvement based on the findings.
• Support Revenue Cycle in maximizing the use of standardized workflows
• Promote a patient centered financial advocacy environment.
• Track and assist in resolution of denials and no-authorization write-offs
• Guides and advises less-experienced Business Systems Analysts
• Perform special project and other duties as assigned

A Bachelor's degree in Information Technology, Business Administration, Health Care Administration or related field, or an equivalent combination of education and/or experience is necessary.

2-3 years experience in a centralized authorization unit within a healthcare setting. Ability to perform business analysis.

Demonstrated ability to work independently and collaboratively with teams of all sizes.

Strong computer skills and ability to adapt to new technology.

Outstanding organizational skills and ability to prioritize multiple tasks with competing deadlines is required to effectively work to meet deadlines.

Effective interpersonal and communication skills.

Knowledge and experience with MiChart.

Front-end clinical experience with authorizations.

Ability to troubleshoot and resolve problems, provide user support, create reports, and communicate to management.

Must be proficient in workflow documentation software such as Microsoft Visio etc.

Experience working across UMHS departments to gather requirements and define business needs for system application build and support.

Current Coding certification (CPC) preferred.

Knowledge of MiChart Billing.

Understanding of Lean principles and practices.

Project management skills strongly desired.

Epic certification a plus.

This position may be underfilled at a lower classification depending on the qualifications of the selected candidate.