REIMBURSEMENT DATA ANALYST
REIMBURSEMENT DATA ANALYST
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Salary Not Disclosed
1 Vacancy
Job Description
General Summary
Under general supervision reports analyzes audits and interprets financial patient and charge data to assist management in evaluating and executing hospital business plans to maximize revenue and maintain compliance with Health Services Cost Review Commission (HSCRC) and Center for Medicare and Medicaid Services (CMS) regulations. Provides support to other members of finance clinical departments and hospital staff. Analyzes reports and assists with the interpretation of hospital specific volume data. Serves as corporate liaison to assigned services/hospitals and supports other team members. The employee will be assigned to a specialized functional area such as case mix charge description master (CDM) policy and methodology and/or rate setting.
Principal Responsibilities and Tasks
The following statements are intended to describe the general nature and level of work being performed by people assigned to this classification. These are not to be construed as an exhaustive list of all job duties performed by personnel so classified.
- Produces and distributes routine internal reports for monthly financial processes and revenue maximization initiatives to include but not limited to reimbursement strategies case mix audits clinical documentation reviews CDM audits and quality-based reimbursement programs.
- Produces and submits various reports and data submissions to external agencies. Ensures complete and accurate data capture in compliance with published regulations and deadlines for assigned hospitals.
- Assists with the development and coordination of educational in-services to clinical departments CBO IS&T and other administrative staff related to CPT CMS and HSCRC regulations as well as charging and billing issues.
- Responsible for performing audits with a focus on accuracy maintaining compliance with regulatory agencies and assisting facilities with charge capture billing coding clinical documentation and compliance issues.
- Analyzes reports to determine areas of improvement or in need of further investigation; determines appropriate plan of action and works with department to rectify any charge capture problems. Exhibits a general knowledge of hospital specific charge capture processes to be able to effectively resolve issues.
- Provides analytical and technical support regarding hospital volume changes and helps to resolve the issues identified.
- Monitors and analyzes variances in financial patient-level coded and charge data to determine areas of improvement or in need of further investigation. Determines appropriate plan of action and works with departments and others to coordinate resolution of issues and identification of opportunities for improvement.
- Fulfills ad-hoc data and reporting requests as needed.
- Assists team members and management in developing enhancing and maintaining standard processes reports databases and reference data to support accurate consistent efficient and quality service to internal and external customers.
- Participates in testing and data validation during new system implementations and upgrades to existing systems.
- Attends and participates in in-service training and various educational programs for continuous professional development.
Qualifications :
Education and Experience
- Bachelors degree is required. Specialization in Healthcare Finance Accounting or equivalent related subject is preferred.
- Prior financial and/or data work experience is preferred.
- Healthcare-related finance background is preferred.
Knowledge Skills and Abilities
- Ability to process assess and summarize large amounts of financial and clinical data into useful information.
- Knowledge and experience with spreadsheets word processing and other finance related software programs. Knowledge of databases (MS-Access) SAS and/or Tableau preferred but not required.
- Understanding of data flow and information systems of business operations.
- Concern for quality and ability to identify errors and implement corrections.
- Effective verbal and written communication skills are necessary in dealing with a variety of healthcare and finance professionals including senior management staff.
- Ability to work effectively in a matrix work environment and to manage multiple deadline-driven tasks and projects.
- Minimal knowledge or demonstrated ability to learn and understand HSCRC/CMS regulations CPT (Current Procedural Terminology) and ICD-10 coding.
- Ability to operate a personal computer is required. Proficiency with the following applications is required: MS Excel MS Word and PowerPoint. MS Access SAS & Tableau is preferred.
- Ability to handle confidential issues with integrity and discretion.
- Ability to prioritize and manage work in a stressful environment.
Additional Information :
All your information will be kept confidential according to EEO guidelines.
Compensation:
Pay Range: $27.44- $38.41
Other Compensation (if applicable):
Review the 2024-2025 UMMS Benefits Guide
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Remote Work :
Yes
Employment Type :
Full-time
Employment Type
Remote
Company Industry
Key Skills
- Data Analytics
- Microsoft Access
- SQL
- Power BI
- R
- Data Visualization
- Tableau
- Data Management
- Data Mining
- SAS
- Data Analysis Skills
- Analytics
