Catholic Health Initiatives REVENUE CYCLE ANALYST SR (Mountain Management) Full-Time (P000097695) in CHATTANOOGA, Tennessee

REVENUE CYCLE ANALYST SR (Mountain Management) Full-Time (P000097695)

Description

Job Summary:

This job is responsible for developing in-depth and complex financial analyses in support of the Franciscan Medical Group (FMG) Revenue Cycle function and for the development/maintenance of advanced ad hoc reports/databases consistent with industry standards, internal policies/procedures and general requirements. Reports are produced for Revenue Cycle functions such claims submission, insurance follow-up, cash management, credits/refunds, charge/payment posting, coding and clinic customer service. An incumbent interprets/analyzes report content and develops presentations for key stakeholders, including providers, clinic management and organizational leadership. Strong communication, analytical and critical thinking skills are required for timely report generation/distribution through use of computer-based applications and data.

Work also includes: 1) developing/maintaining KPI (Key Performance Indicator) dashboards, reimbursement and payer mix analyses and clinic/business operational reports; 2) interpreting/explaining report findings to clinic management/organizational leadership and recommending process improvements; 3) overseeing Chargemaster maintenance; 4) serving as principle liaison between business operations leaders and Information Technology (IT), facilitating technology/tools enhancements and system maintenance/modification; and 5) providing training/guidance to other Revenue Cycle staff with regard to reporting, analytics and related tools.

Work requires considerable knowledge of the standards, practices, and requirements relating to insurance payers/plans, insurance reimbursement and payer mix, as well as financial analysis/modeling. Knowledge of relational database management, HTML, SharePoint and SQL programming, and considerable expertise with the Microsoft Office Suite (Excel, Outlook, PowerPoint, Access and Visio) and electronic medical record systems is also required.

Essential Duties:

  1. Designs, develops and tests reports and desktop databases to facilitate efficient and flexible data extraction and management; develops and maintains timely and accurate documentation related to development, reporting and analytical activities.

  2. Retrieves and manipulates data from the health information system(s), including design, customization, and report and dashboard generation for stakeholders.

  3. Develops authorized procedures and seeks assistance when guidelines are inadequate, significant deviations are proposed, or when unanticipated problems arise.

  4. Provides management with weekly, monthly, quarterly, and annual updates/summaries of key performance indicators for identified departments.

  5. Monitors ad hoc reporting requests and responds to/fulfill requests within pre-determined service timeframes.

  6. Analyzes department/team activities and trends and compares findings against the service standards and industry best practices.

  7. Prepares and effectively leads presentations with key stakeholders and organizational leaders as relates to compiled analyses and reports.

  8. Gathers information for various financial projects, including payer contract negotiations, payment variance analysis, and reimbursement analysis; runs ad hoc reports as needed; performs in-depth analysis; summarize results and recommendations.

  9. Ensures that relevant changes are fully understood and that current data/reports are updated to ensure timely and accurate information is accessible and produced.

  10. Identifies, researches and resolves (within position scope) unusual, complex or escalated issues through critical thinking and problem solving skills; notifies Supervisor/Manager/Director of ongoing issues and concerns.

  11. Independently analyzes/interprets/explains complex report content/findings and makes recommendations for revenue cycle process improvements; provides updates to clinic leadership on reimbursement changes, payer mix and realization dates.

  12. Independently performs complex research, compiles financial analyses, and develops detailed spreadsheets and presentations; prepares in-depth analyses focused on accuracy, reliability, and timeliness; provides/presents interpretation of findings to senior leaders, colleagues, clinic managers, and/or physicians.

  13. Develops analyses and reports to support key initiatives, including identification and recommendation of improvements to existing processes, with timely follow-through as appropriate.

  14. Monitors weekly performance metrics and completes root cause analyses to identify metric improvement opportunities related to regional revenue cycle activities.

  15. Identifies and makes recommendations to improve existing processes and follow through as appropriate.

  16. Applies a test of reasonableness to question results of each analysis before the task/analysis is complete.

  17. Documents processes as well as source information and calculations used in financial analyses.

  18. Provides oversight of the FMG Chargemaster and system procedure code table in accordance with established procedures.

  19. Develops and maintains processes and spreadsheets for annual pricing analytics, including the creation of detailed impact analyses, coordinating/importing payer reimbursement schedules into SQL/Excel, and developing annual price change recommendation proposals for Leadership evaluation.

  20. Oversees the development of the Chargemaster spreadsheet for fee schedule additions and maintenance requests.

  21. Audits fee schedule additions and system changes coordinated by the Revenue Cycle Analyst; provides additional education/training as needed.

  22. Leads liaison activities between business operations leaders and Information Technology (IT) department to promote a partnership that develops/enhances systems, tools, technology and processes.

  23. Serves as primary liaison with CHI IT to assist FMG with implementing new tools, technology, reporting solutions, and analytics:

  24. Participates in the design, build, and validation of system tables and processes

  25. Proposes system set up for consideration by CHI

  26. Trains staff on system functionality

  27. Develops reference guides for new tools, technology, process and report maintenance/use.

  28. Monitors integrity of system department/facility/provider and workqueue edit changes for Revenue Cycle.

  29. Provides technical expertise required to maintain and enhance internal SharePoint and Intranet sites; coordinates with IT as needed.

  30. Communicates technical changes/suggestions to operational leaders.

  31. Maintains current knowledge of internal, industry, and government regulations as applicable to assigned function; maintains confidentiality of medical records and related data.

  32. Has knowledge of, and is compliant with, government regulations including "signature on file" requirements, compliance program, HIPAA, etc.

  33. Establishes and maintains professional and effective relationships with peers and other stakeholders; assists in training/coaching Revenue Cycle Analyst in reporting/analytical activities.

  34. Works collaboratively with Revenue Cycle team members and other stakeholders to meet expectations and deliverable timelines.

  35. Establishes and maintains a professional relationship with clinics and FMG staff in order to resolve issues.

  36. Promotes an atmosphere of collaboration so Revenue Cycle team members feel comfortable approaching with issues and challenges.

  37. Depending on role and Epic training, may be called upon to support other areas in the Revenue Cycle.

  38. Performs related duties as required.

Qualifications

Education

  • Bachelor's Degree in Business Administration, Finance, Accounting or Related healthcare field.

Experience

  • 5 years Leadership Experience in the discipline

  • OR

  • Master's Degree and no experience

Additional Responsibilities:

Demonstrates a commitment to service, hospital values and professionalism through appropriate conduct and demeanor at all times.

  • Adheres to and exhibits our core values: Reverence: Profound respect and awe for all of creation, the foundation that shapes spirituality, our relationships with others and our journey to God. Integrity: Moral wholeness, soundness, fidelity, trust, truthfulness in all we do. Compassion: Solidarity with one another, capacity to enter into another's joy and sorrow. Excellence: Preeminent performance, becoming the benchmark, putting forth our personal and professional best.

  • Maintains confidentiality and protects sensitive data at all times.

  • Adheres to organizational and department specific safety standards and guidelines.

  • Works collaboratively and supports efforts of team members.

  • Demonstrates exceptional customer service and interacts effectively with physicians, patients, visitors, staff and the broader health care community.

Catholic Health Initiatives and its organizations are Equal Opportunity Employers

NOTICE

This position requires a criminal background check. Therefore, you may be required to provide information about your criminal history in order to be considered for this position.

Job Finance

Primary Location TENNESSEE-CHATTANOOGA-MOUNTAIN MANAGEMENT OFFICE

Daily Schedule 1st

Scheduled Hours per 2-week Pay Period 80

Weekends Required None

Req ID: 2017-R0132099