What are the responsibilities and job description for the Payment Analyst, Corporate Office position at ALLIED SERVICES?
GENERAL SUMMARY:
Under the direction of the Assistant Director of Patient Accounts. the Payment Analyst is responsible for verifying all payments, received by the Patient Accounts Department, are proper; as per Allied Services contracts and federal and state regulations.
The Payment Analyst is responsible for knowing and understanding federal and state regulations as they relate to healthcare billing and reimbursement. The Payment Analyst is responsible for knowing and understanding Allied Services contracts as they relate to healthcare billing and reimbursement. The Payment Analyst is responsible for building and maintaining all contracts and federal and state regulations the various software applications. The Payment Analyst is responsible for identifying all underpayments and overpayments and assigning to the appropriate staff for follow up. The Payment Analyst is responsible for maintaining accurate accounts receivable balances from time of first bill through payment in full. The Payment Analyst develops and implements education and training of the Patient Accounts Department to be in compliance with federal, state and contract terms.
EDUCATION:
Associates degree in business or information technology required
Bachelor’s degree in business or information technology preferred
WORK EXPERIENCE:
Minimum of five years in Healthcare Facility setting preferred
Minimum of three years in Healthcare Facility setting required
CHARACTERISTIC DUTIES & RESPONSIBILITIES OF JOB:
Reviews all payment queues in HPF (Horizon Patient Folder) to verify that each payment received is appropriate and correct. Each payment is researched to confirm that it was posted to the correct patients account, that each payment was posted against the correct services on each patients account, that each payment was for services provided and billed, and that each payment is according to contract terms and/or federal and/or state regulations. Incorrect payments are identified and researched. Decision is made on most appropriate action for follow up and then assigned to a Patient Account Representative.
Maintains patients account balances by posting contractual allowances, adjustments, small balance write offs, A/R payer transfers and payment transfers as appropriate. Also reclassifies and rebills patient accounts to correct payers for accurate contract term application.
Responsible for reviewing and understanding all new contracts, addendums to contracts and rate changes. Responsible for reviewing and understanding all new and updated federal and state regulations and reimbursement. Builds and maintains all contract terms and regulatory updates in McKesson Pathways Contract Manager (PCON), McKesson Series and PointClickCare (PCC). Responsible for testing each build and verifying adjustments and expected payments are correct. Tests interfaces between systems for seamless transition. Reviews and resolves all error and variance reports.
Keeps management aware of trends and issues with respect to incorrect payments. Advises management where education or training is needed when incorrect payments are related to billing.
Assists third-party auditors for fiscal year end audits.
Assists in preparation of statistical reports.
Participates in formal training and educational seminars as required.
