University Healthcare System

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Reimbursement Analyst

at University Healthcare System

Posted: 7/6/2019
Job Reference #: 9928

Job Description

  • Job ID
    2019-9928
    Category
    Other Professional/Technical
    Department
    9170 - Patient Finance Administration
    Shift
    8:00 am - 5:00 pm
    Pay Grade
    14
    FT/PT/PRN
    Full Time
    Recruiter
    Mac McCord
    Recruiter Email
    macmccord@uh.org
    Location
    US-GA-Augusta
  • Responsibilities

    Ensures that University Hospital is paid timely and correctly by payers for the services rendered to their beneficiaries. Using a broad variety of automated claims management, tracking, and ancillary systems, the Analyst analyzes incoming payment information and other communications (from payer, physician, and patient) along with applicable contract terms, reimbursement schedules, government regulations and internal policies. If payment is incorrect, untimely, and/or the payer is denying partial or full responsibility for the claim, the Analyst researches the claim, determines what actions are needed to obtain full payment on the claim, takes those actions and documents the account appropriately. Determines whether or not any remaining balance should be written off (or for large dollar balances, referred higher for write-off decision). Regularly monitors unpaid underpaid and denied claims to ensure that they are brought to full resolution. Ensures that all actions taken are consistent with a broad variety of government regulations, contractual terms and internal policies and procedures. Communicates and coordinates with a broad variety of individuals to include patients, physicians, all levels of University Hospital employees, and payer representatives.

    Qualifications

    Education
    Bachelor's Degree in Accounting, Business Administration or related field required. May consider substitution of 2 years of additional related experience with 2 years of college or relevant tech school education for Bachelor's degree.

    Licensure/Certification
    CPAR or similar certification desired. Medical terminology and basic ICD/CPT coding certification/coursework required or must obtain within 12 months of assuming position.

    Experience
    Minimum three years accounting or business experience required. Strongly prefer at least one year experience in third-party medical claims management/reconciliation or other closely related experience in a hospital or other medical setting.

    Proficient keyboarding (min. 35 wpm) and PC skills to include word-processing, email, and internet are required. Experience with MSWord, Excel, Lotus Notes and Healthquest Patient Accounting System preferred. 10-key calculator/keypad skills "to touch" a plus.

    Knowledge, Skills and Abilities
    Knowledge of all of the following - as demonstrated by experience, formal education or related certification is required Third-party reimbursement methodology Insurance claims processing Registration and billing processes Medical terminology Medical coding concepts (ICD9/10 and CPT)

    Strong analytical ability, problem-solving and critical thinking skills are required. Basic math skills must include proficiency at multiplication, division, calculation of percentages and averages, and mental estimation. Ability for attention to detail and accuracy is critical.

    Strong organization skills and ability to independently prioritize multiple competing responsibilities are a must.

    Requires well-developed communication, interpersonal, and negotiation skills; ability to be assertive while maintaining a professional manner; and competence in working as part of a team.

    Physical Demands
    Required to sit steadily and focus on a computer screen with minimum breaks for up to 90% of the workday. Must be able to read/view electronic and hard copy documents, create electronic and hardcopy documentation in existing systems, and make/receive frequent phone calls.

    Not ready to apply? Connect with us for general consideration.