We are looking for a detail-oriented and analytical professional to join our team. The role involves extracting, preparing, and analyzing complex data, accounts, and financial reports. You will be responsible for reviewing trends, presenting findings, and advising leadership on strategic decisions to improve financial performance and reduce denials. As a subject matter expert, you will play a key role in driving initiatives and serving as a resource for various departments.
Key ResponsibilitiesAnalysis, Trending, Support, and Liaison (70%):
Denial and Payor Trends Analysis: Conduct detailed research to identify trends in denials and payor behaviors, review account specifics, and provide validated findings and recourse for denied accounts or avoidable adjustments.
AR Aging Reduction: Offer in-depth reviews and recommendations to reduce aging accounts receivable (AR), avoidable write-offs, and high-dollar AR.
Reporting and Presentation: Prepare and present written reports and analyses to leadership, highlighting trends and offering actionable recommendations.
Decision-Making Support: Act as a subject matter expert, aiding leadership in decisions related to denial prevention strategies and managing change effectively.
Stakeholder Communication: Liaise with entity management and staff, document and discuss reports, trends, and recommendations.
Technical Resource: Provide technical support to operational management on interpreting denial and financial data, and mentor staff on AR and financial systems, analyses, reports, and procedures.
Weekly Reviews: Continuously review weekly invoice analyses to identify opportunities for process improvement, prevent aging, denials, and avoidable write-offs.
Collaboration: Work closely with other analysts and departmental resources to enhance workflow processes and reduce aging AR.
Skill Development: Expand knowledge of Excel, documentation analysis, PowerPoint presentations, dashboard reviews, and Epic reporting mechanisms.
Performance Enhancement: Improve communication and presentation of material to leadership in monthly meetings and through email requests, focusing on AR summaries.
Claims Edits: Evaluate and implement claim edits to reduce denials and improve AR turnaround time.
Trending and Analysis: Maintain organized reports and identify process improvement opportunities, including staff training, workflow changes, system enhancements, and policy updates.
Issue Resolution: Maintain and update issue logs, working with Payer Relations to resolve denial trends.
Committee Leadership: Organize and lead A/R and denial management committee meetings.
Technical Expertise (25%):
Departmental Knowledge: Develop and maintain comprehensive knowledge of all functions performed by the department, including relevant payer billing requirements, reimbursement regulations, and operational policies.
System Proficiency: Gain proficiency in systems like Maestro Care, EPIC, Excel, Microsoft Word, PowerPoint, and other necessary software.
Ad Hoc Reporting: Provide ad hoc reporting to senior leadership as needed.
General Responsibilities (5%):
Team Environment: Contribute to a positive working environment and perform other duties as assigned to enhance overall departmental efforts.
Continuous Improvement: Participate in ongoing professional development and training opportunities.
EducationMinimum Qualifications:
Bachelor's Degree in business, healthcare administration, accounting, finance, or a related field.
ExperienceMinimum of four years of relevant experience.
Proven track record of successfully managing complex projects involving multiple stakeholders, delivering high-quality results on time.
A Master's degree in a related field can substitute for two years of experience on a 1:1 basis.
Employment Type: Full-Time