Community Health Systems Revenue Cycle Analyst/Physician Services in Brentwood, Tennessee

Description:

Assist in the directing and coordinating the overallfunctions of the Revenue Cycle to ensure maximization of cash flow and increasenet collections while improving patient, physician and other customerrelations. Performs task to prepare and review reports.

DUTIES AND RESPONSIBILITIES:

  • Responsible for analyzing and presenting data incoordination with clinical and financial management goals, benchmarks andobjectives in assigned area;

  • Complies daily with departmental policies and procedures;

  • Perform revenue and usage analysis at the facility level tofind potential billingand revenueopportunities.

  • Support and assist Hospital and Physician team members withdifficult issues concerning work, clients and/or insurance carriers; offersuggestions to assist in process of underpayment reviews and collections.

  • Resolves claims processing issues with commercial andgovernmentalpayers and provide allrequired information timely; involves patients and family members (wherenecessary) to ensure timely resolution of claims with insurance companies;

  • Responsible for making sure the facilities understand thestandard charging guidelines and how to correct charge errors goingforward.

  • Resubmits clean and accurate claims to insurance companiesin a timely and compliant manner;

  • Researches, prepares, and submits appeals to insurancecompanies;

  • Details all actions taken on account with clear and concisenotes;

  • Monitors and recognizes denials and/or issues that may betrends and escalate to supervisor as needed; and

  • Maintain strict confidentiality and adhere to all HIPAAguidelines/regulations.

  • Resolve charging/chargemaster/revenue integrity issues withother departments within the company (i.e. HIM, Information Systems, Complianceand Managed Care)

  • Perform various monitoring tasks that identify revenueintegrity opportunities.

  • Working knowledge of Athena

Qualifications

KNOWLEDGE, SKILLS AND ABILITIES:

  • Knowledge of basic medical coding/terminology andcommercial/government insurance operating procedures and practices ;

  • Understands payer guidelines related to effective claimresolution;

  • Knowledgeable and proficient with payer websites and otheruseful resources;

  • Knowledge of revenue cycle and/or business officeprocedures;

  • Highly detail oriented and organized;

  • Ability to read, understand, and follow oral and writteninstructions; and

  • Ability to establish and maintain effective workingrelationships and communicate clearly with customers and insurance companiesboth within and outside of Quorum Health Systems.

WORK EXPERIENCE, EDUCATION AND CERTIFICATIONS:

  • Education – High School diploma or equivalent

  • 5 years in relevant Healthcare experience

TRAVEL REQUIREMENTS:

Travel is infrequent.

Job: Corporate Positions

Organization: QHC

Location: TN-Brentwood

Requisition ID: 1838460

This organization does not discriminate in any way to deprive any person of employment opportunities or otherwise adversely affect the status of any employee because of race, color, religion, sex, sexual orientation, genetic information, gender identity, national origin, age, disability, citizenship, veteran status, or military or uniformed services, in accordance with all applicable governmental laws and regulations. In addition, the facility complies with all applicable federal, state and local laws governing nondiscrimination in employment.