Reimbursement Analyst I

University of Connecticut    Farmington, CT
Job Description

At UCHC this position is responsible for independently performing a full range of tasks in reimbursement analysis, including development of procedures to ensure recovery of all inpatient and outpatient charges, contract management, external financial reporting, revenue capture, accounts receivables analysis and regulatory compliance monitoring.

MINIMUM QUALIFICATION REQUIRED:

KNOWLEDGE, SKILL AND ABILITY:

Considerable knowledge of the principles and practices of financial management; knowledge of the healthcare reimbursement; considerable ability in the interpretation and analysis of complex financial, statistical and technical data; considerable interpersonal skills, oral and written communication skills; considerable knowledge of insurance billings and collection procedures including CPT and ICD-9 coding; advanced spreadsheet and computer skills; advanced analytical skills; supervisory ability; knowledge and ability to apply relevant Federal and State laws, statutes and regulations; knowledge of statistical methodologies

EDUCATION AND TRAINING:

General Experience: Six (6) years experience in healthcare environment related to revenue captures, healthcare reimbursement procedures, including working knowledge of CPT and ICD- 9 codes.

Substitution Allowed:

Bachelor’s degree in financial management, accounting, healthcare administration or closely related field may be substituted for four (4) years of the experience.

SPECIAL REQUIREMENTS: Advanced proficiency with Excel spreadsheets including pivot tables and advanced formulas.


PREFERRED QUALIFICATIONS: Master s Degree in healthcare administration, accounting, business, or relate field. Working knowledge of hospital operations and reimbursement methodologies.


SUPERVISION RECEIVED:

Works under the general supervision of an employee of higher grade.

SUPERVISION EXERCISED:

May lead staff as assigned.

EXAMPLES OF DUTIES:

  • Develops techniques, such as variance reporting, for effective analyses of reimbursement trends and provides reimbursement patterns and trends to management;

  • Reviews, analyzes and interprets insurance payments and denials to ensure proper payment;

  • Works with billing supervisors and charge-master analyst to modify billings to meet contract specifics;

  • Recommends updates to charge-master;

  • Develops and maintains system for tracking and evaluating performance of insurance carrier to maximize reimbursement and ensure billing compliance with audit standards;

  • Prepares reports and analyses to include financial reports and statements of Profit and Loss, setting forth progress, adverse trends and appropriate recommendations and conclusions;

  • Submits external reports and handles all edits and changes required by meeting with appropriate departments to obtain correct data;

  • Monitors and evaluates current reimbursement rules and changes that impact revenue capture and communicates this information to the clinical faculty, staff, and billing personnel;

  • Provides in-service training for finance personnel;

  • Develops and recommends policies and procedures;

  • Applies personnel policies and procedures;

  • Prepares or assist in the preparation of the department budget subject to administrative review;

  • Acts as liaison with other operating units, agencies and outside officials regarding third party reimbursements;

  • Special projects as assigned by the AVP or Chief Clinical Revenue Cycle Officer.

  • performs other related duties.


SCHEDULE: 40 hour work week, Monday through Friday, 8am - 5pm; 1 hour unpaid meal break.


FULL TIME MINIMUM EQUIVALENT SALARY: $63,898


Tue, 10 Dec 2019 21:30:51 GMT

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