Patient Accounts Analyst (Revenue Cycle - Operations)
Location: Burr Ridge, IL
The Finance Revenue Cycle Department has an opportunity for a Patient Accounts Analyst - Revenue Cycle Operations .
Patient Accounts Analyst – Job Summary
In the role, the Patient Account Quality Assurance activity for the Hospitals with an Emphasis on ensuring that billing (focused Governmental and Non-Governmental) processes are in compliance and on operational activities for management and clerical staff (all patient account department functions). This roles primary functions will consist of various tasks related to Quality Assurance QA, Analysis, Process Improvment and research.
- Works as primary analysts and testing support on Patient Accounting and Clinical systems module/step installations, upgrades and fixes; working with IT and operations resources.
- Works on projects for Patient Accounting and Clinical systems to support activities related to Medicare, Medicaid and all third party billing and collection of claims.
- Assists in overseeing the patient accounting and revenue cycle areas including charge entries, bill holds, coding initiatives, forms and data capture, etc.
- Reviews and makes recommendations on patient account and revenue cycle procedures/policies as they pertain to quality assurance.
- Is involved with external patient accounting audits, gathers and interprets government, state and private payer regulations.
- Reviews hospital enrollment statuses and reviews admission, billing and collection practices as appropriate. Assists with analysis of, tracking of and review of all internal/external audit requests.
- Serves as liaison to other hospital departments regarding policy and procedure interpretation as it relates to efficient Medicare, Medicaid, dual eligibility,
- State and federal HMO's and all third party regulations, reimbursement and ensures patient accounts processes and procedures are in place and adhered to.
- Works with Revenue Cycle Management in assigning the appropriate billing codes and initiates changes to facilitate the all billing processes.
Patient Accounts Analyst – - Essential Job Functions
- Assists with the interpretation and implements regulatory issues related to billing/collection, and clinical trials. Must be familiar with all governmental agencies related to billing and collections. Remains familiar with and complies with all federal and state health care laws, regulations, and rules including applicable Medicare, Medicaid and Private payer billing requirements. Remains on top of all new billing regulations, especially Medicare billing changes and communicate changes to appropriate areas. Reports any possible noncompliance with applicable laws to immediate manager or hospital compliance hotline. Acts as a liaison between finance, HIM, and compliance office as needed.
- Audits Patient Accounts System master files; such as charge master and insurance master, etc.
- Reviews and assists in the development and audit of patient accounts and revenue cycle related policies and procedures. Assists Managers and Directors in developing and documenting policies/procedures. Reviews and reports on corrections to non-covered billing processes, credit balance process, patient correspondence, system generated letters and statements, and staff generated communications, to ensure the highest quality product is submitted to adhere to policies governing patient confidentiality. Performs monthly A.R. Maintenance on Accounts Receivable by requesting and reviewing approved write-off' criteria. Works with other departments within the Hospitals and with external organizations to assure that financial issues and decisions on policy/procedure for financial workflows are followed.
- Participates in all system upgrades and changes that relate to Patient Accounts. Works as primary analysts and testing support on Patient Accounting and Clinical systems module/step installations, upgrades and fixes; working with IT and operations resources. Assists in overseeing development, installation and/or implementation of new computer based systems, and changes to existing systems as they affect patient accounting services. Assists in problem solving on all internal and external systems. i.e. 3M, Centricity, Intercept, Medicare, Passport, Ecare, Craneware, Artiva, etc. Responds to internal areas questions, and provides assistance related to systems. Coordinates and takes the lead on special projects
- Reviews billing, denial, rejection, and delays trends. Review and Approve Late Charge entry requests. Creates new finance accounts, process adjustments to write off the charges on a monthly basis. Processes charge overrides of pro-fee charges on Medicaid accounts for services performed by Assistant Physician Nurses (APNs). Performs manual coding of claims and follow-up on all Medicare Inpatients receiving Factor Drugs to receive additional add-on payments from Medicare. Assists billers, hospital administrators, pre-billing and clinic staff in resolving complex accounts and patient problems that may result in nonpayment of hospital bills. Assists the Revenue Cycle Management Department with the correct assignment of revenue codes and CPT/HCPCS codes to ensure claims are accurately presented to Medicare and other third party payers.
- Serves as liaison to other hospital departments regarding policy and procedure interpretation as it relates to efficient Medicare, Medicaid, dual eligibility, State and federal HMO's and all third party regulations, reimbursement and ensures patient accounts processes and procedures are in place and adhered to. Participates in committees and forums as a representative of the Hospitals on financial issues. Assists in the selection and ongoing monitoring of external agencies working on behalf of the Hospitals.
- Maintains bill hold edits from current NEBO/ECARE electronic billing system, ensures claims are billed correctly (according to government billing rules), implements and works with IT staff and tests new bill holds, tests billing requirements and/or changes from governmental agencies to ensure that the changes made by IT are working prior to installation into the production environment in Centricity. Assists in overseeing the patient accounting and revenue cycle areas including charge entries, bill holds, coding initiatives, forms and data capture, etc.
- Performs other duties assigned.
Patient Accounts Analyst – Qualifications
- Undergraduate degree and/or AA in Business, Finance or Accounting, preferred and/or applicable years of experience
- Minimum five to seven years of progressively increasing management and operational experience in an AMC, large hospital financial or financial systems department; extensive knowledge of general hospitals software systems desirable.
- Excellent analytical and problem solving skills, ability to independently handle multiple priority projects simultaneously and efficiently, organized and assess work to meet deadlines.
- Excellent verbal, written communication, presentation, leadership, and project management skills; with ability to work as a part of a team.
- Ability to understand and interpret federal regulations, work independently and interact effectively with people in a variety of contexts, team player.
- Ability to use Microsoft Office Suite including MS Word, Excel, Access, PowerPoint, Project and Visio and applicable systems
Why Join Us?
We've been at the forefront of medicine since 1899. We provide superior healthcare with compassion, always mindful that each patient is a person, an individual. To accomplish this, we need employees with passion, talent and commitment… with patients and with each other. We're in this together: working to advance medical innovation, serve the health needs of the community, and move our collective knowledge forward. If you'd like to add enriching human life to your profile, The University of Chicago Medicine is for you. Here at the forefront, we're doing work that really matters. Join us. Bring your passion.
Bring your career to the next level at a hospital that is thriving; from patient satisfaction to employee engagement, we are at the Forefront of Medicine. Take advantage of all we have to offer and #BringYourPassiontotheForefront
University of Chicago Medicine is growing; discover how you can be a part of this pursuit of excellence at: www.uchospitals.edu/jobs
The University of Chicago Medical Center is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, ethnicity, ancestry, sex, sexual orientation, gender identity, marital status, civil union status, parental status, religion, national origin, age, disability, veteran status and other legally protected characteristics.
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