Community Health System Antioch , TN 37011
Posted 5 days ago
Job Description
Essential Duties and Responsibilities include the following. Other duties may be assigned:
Identify trends in underpayment/overpayments, denials, revenue opportunities and revenue leakage
Evaluate trends and works towards resolution and improvement of revenue cycle processes
Interpret contract reimbursement and provide feedback to management staff as required
Manage underpayment appeals, account follow-up and payer relationships
Compile and analyze data to make recommendations
Work with financial and clinical departments collaboratively
Review contract validation, updates and interpretation
Resolve underpaid claims in an effective and timely fashion
Review payer policies for impact on reimbursement
Present data to various end users
Compile and validate account analysis prior to distribution
Research and identify payment discrepancies from various sources
Other duties as assigned
Qualifications:
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Highly organized
Initiative to work independently
Proficient with telephone and email communications
Basic understanding of medical coding systems affecting the adjudication of patient accounts in EDI or UB04 form,
including: ICD-9, CPT, HCPCS, DRG, APG, APC, and revenue code structures
Reasoning Ability:
The analyst must have the ability to define problems collects data, establish facts, and draw valid conclusions. The analyst must have the ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
Computer Skills:
To perform this job successfully, an individual should have:
symbolic representation and procedural logic
Physical Demands:
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education/Experience/Skills:
High School graduate or equivalent
Minimum of 1 (one) year of hospital revenue cycle experience or equivalent work experience
Excellent interpersonal skills required to communicate with direct staff and internal/external customers
Must possess excellent time management and organizational skills with great attention to detail
Maintain applicable continuing education requirements
The ability to work on multiple projects/initiatives at a time
INDSS
Community Health System