UNC Health Care REIMBURSEMENT ANALYST-DENIALS MANAGEMENT in Chapel Hill, North Carolina
REIMBURSEMENT ANALYST-DENIALS MANAGEMENT
Job ID: OTH01MBS
REIMBURSEMENT ANALYST-DENIALS MANAGEMENT-OTH01MBS
Location:Eastowne, Chapel Hill
Hours:Full-time, 40 hrs,Monday-Friday
InternalHCS employees have priority for consideration.
This position may involve support of various hospitals and health care systems within the UNC Health Care System, but will be employed by Rex Hospital, Inc. (this includes, but is not limited to, for purposes of payroll, health benefits, retirement options, and applicable policies). If selected candidate is currently employed with UNC Health Care System the candidate will stay on current payroll and benefits platform.
Performs a variety of operational and financial analyses and reporting in order to maximize the collection of all billable charges. Employees work independently under the direction of an administrative superior and may serve as a project team coordinator or leader, working with staff from various levels of operation to resolve a particular issue. Employees work closely with clinical managers and staff to improve revenue flow.
Assesses accuracy of billing and conductspreventable write off adjustmentaudits. Recommends, and assists in implementing corrective actions resulting from reviews.
Assists in designing specific procedures and systems changesto prevent denials or revenue losses. Coordinates with external organizations (including drug manufacturers and insurance carriers) on projects and issuesto reduce denials.
Educates physicians and other clinic and administrative staff on concepts, issues and processes related todenials. Prepares communications and training materials. Drafts technical documentation such as user guides for reimbursement systems and procedures.
Monitors and analyzes a variety of data from internal and external sources to identify trends in reimbursement denials. Develops and execute reports which aid in analysis of financial data to determine root causes of problems. Charts and tracks revenue-related changes (e.g., charges, receipts, third party sponsorship, collection rates) over time.
Prepares appeals of third party decisions. Conducts background research collects data assembles documentation and follows up with agency to obtain decisions. Serves as liaison and manages records and files of such appeals. Directs mass claim refiles,
Recommends changes to processes and other revenue structures. Recommends additional opportunities for increased revenue based on analyses
Serves on cross-departmental project teams to design, plan and implement changes in the operational processes and programming to enhance current processes and develop more efficient processes. Serves as special projects coordinator in systematic problem resolution.
Bachelor’s degree in an appropriate discipline (or equivalent combination of education, training and experience).
If a Bachelor's degree: No experience required.
If an Associate's degree: Four (4) years of experience in business analysis and planning, accounting, finance, health care administration or data base management/analysis.
If a High School diploma or GED: Eight (8) years of experience in business analysis and planning, accounting, finance, health care administration or data base management/analysis.
Primary LocationUnited States-North Carolina-Chapel Hill