Community Health Systems Analyst – Payment Compliance in Franklin, Tennessee
Community Health Systems Professional Services Corporation, CHSPSC,LLC is one of the leading operators of general acute care hospitals. The organization's affiliates own, operate, or lease 199 hospitals in 29 states.
Community Health Systems Professional Services Corporation, CHSPSC,LLC seeks an Analyst-Payment Compliance for its Franklin, TN, headquarters Revenue Cycle Service Center team.
The Analyst is responsible for the maximization of reimbursement by identifying contractual variances between posted and expected reimbursement revenue opportunities for managed care, government contracts, and other various payors. This responsibility encompasses contractual reimbursement analysis and communication of payment discrepancies to internal and external departments.
Essential Duties and Responsibilities include the following. Other duties may be assigned.
Identify trends in underpayment/overpayments, denials, revenue opportunities and revenue leakage
Evaluate trends and works towards resolution and improvement of revenue cycle processes
Interpret contract reimbursement and provide feedback to management staff as required
Manage underpayment appeals, account follow-up and payor relationships
Compile and analyze data to make recommendations
Work with financial and clinical departments collaboratively
Review contract validation, updates and interpretation
Resolve underpaid claims in an effective and timely fashion
Review payer policies for impact on reimbursement
Present data to various end users
Compile and validate account analysis prior to distribution
Research and identify payment discrepancies from various sources
Other duties as assigned
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirement listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Initiative to work independently
Proficient with telephone and email communications
Basic understanding of medical coding systems affecting the adjudication of patient accounts in EDI or UB04 form, including: ICD-9, CPT, HCPCS, DRG, APG, APC and revenue code structures
The analyst must have the ability to define problems, collects data, establish facts, and draw valid conclusions. The analyst must have the ability to interpret an extensive variety of technical instructions in mathematical or diagram form and deal with several abstract and concrete variables.
To perform this job successfully, an individual should have:
Interest and aptitude in computer-based applications for complex business processes involving Boolean expressions, symbolic representation and procedural logic
Required PC competencies including intermediate Microsoft Office skills
The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
High School graduate or equivalent
Minimum of 1 (one) year of hospital revenue cycle experience or equivalent work experience
Excellent interpersonal skills required to communicate with direct staff and internal/external customers
Must possess excellent time management and organizational skills with great attention to detail
Maintain applicable continuing education requirements
The ability to work on multiple projects/initiatives at a time
Job: Corporate Positions
Organization: Shared Services Center - Franklin
Requisition ID: 1737363