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Reimbursement Analyst - PB Rev Integ & System Support
This job posting is no longer active.
Job ID: 13791
Location: Chapel Hill, NC
Facility/Division: Shared Services
Status: Full Time
Shift: Day Job
Job Description
Description
Become part of an inclusive organization with over 40,000 diverse employees, whose mission is to improve the health and well-being of the unique communities we serve.
Summary:
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.
Responsibilities:
1. Assesses accuracy of billing and conducts reimbursement audits. Recommends, and assists in implementing corrective actions resulting from reviews.
2. Assists in designing specific procedures and systems changes. Coordinates with external organizations (including drug manufacturers and insurance carriers) on projects and issues to maximize reimbursement.
3. Educates physicians and other clinic and administrative staff on concepts, issues and processes related to reimbursement. Prepares communications and training materials. Drafts technical documentation such as user guides for reimbursement systems and procedures.
4. 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.
5. Prepares analyses of department fee schedules and makes recommendations for changes, considering new or changed CPT codes and other relevant information. Produces impact projections to assess the viability of any proposed changes to fee structures.
6. 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,
7. Recommends changes to processes and other revenue structures. Recommends additional opportunities for increased revenue based on analyses.
8. 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.
Other Information
Other information:
Education Requirements:
● Bachelor’s degree in an appropriate discipline (or equivalent combination of education, training and experience).
Licensure/Certification Requirements:
● No licensure or certification required.
Professional Experience Requirements:
● 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.
Knowledge/Skills/and Abilities Requirements:
Job Details
Legal Employer: NCHEALTH
Entity: Shared Services
Organization Unit: PB Rev Integ & System Support
Work Type: Full Time
Standard Hours Per Week: 40.00
Work Schedule: Day Job
Location of Job: US:NC:Chapel Hill
Exempt From Overtime: Exempt: Yes
Diversity Statement
The UNC Health System and the UNC School of Medicine are committed to valuing all people throughout our organization, regardless of background, lifestyle, and culture. A diverse and inclusive work environment for staff and culturally appropriate care for our patients, are essential to fulfilling our UNC Health vision of improving the health of all North Carolinians.
Equal Employment Opportunity
UNC Health is an equal opportunity employer. As such, UNC Health offers equal employment opportunities to applicants and employees without regard to race, color, religion, sex, national origin, age, genetic information, disability, sexual orientation, gender identity or political affiliation.
To verify employment eligibility, UNC Health is committed to Form I-9 and the E-Verify process. Learn further E-Verify details in English or Spanish.
UNC Health supports your right to work. View the Right to Work Statement in English or Spanish.
