Location: Burr Ridge IL - Estancia Corporate Center (UCPG Administration)
This position enhances efficient Revenue Cycle operations by providing oversight to cash reconciliation and credit resolution process thereby identifying issues that can be either prevented or moved to the front end and resolved during payment posting.
The Business Analyst is knowledgeable of cash posting processes, edits, payer rejections, cash reconciliation and credit resolution workflows and uses this knowledge when reviewing trends and recommending changes to enhance payment posting, refund, and credit resolution process.
The Business Analyst serves as a resource for questions about UCPG cash posting, cash reconciliation and credit resolution and works with others to share this information. In addition, this position works with UCPG Finance on broader issues related cash and credit reconciliation and credit resolution reconciliation and reporting/resolution of payer denials.
Oversees the AR Follow-up and denial resolution process with minimal direct oversight.; while also proactively review current workflows for AR resolution with the intention to improve, implement, communicate and maintain an efficient AR resolution process.
Identifies and resolves the systematic and/or operational root causes of denials and outstanding AR. Oversees and manages the AR Follow-up work queues (WQ) and proposes both short and long-term enhancements that support business needs.
Assists manager with maintaining payer scorecards, creating payer meeting agendas, and communicating issues to provider representatives.
Works with the payers on escalated account resolution, identifies and submits high-complexity and other escalated payer projects; as well as proactively review payer communication, initiates payer policy and rule change implementation, and proposes changes to front-end or back-end edits.
Creates simple to moderately-complex reports that are necessary for payor projects using a variety of business tools.
Communicates clearly and professionally with the other UCPG units, clinical departments, external vendors, and payers in effort to build partnerships that result in denial resolution and prevention.
Provides AR follow-up expertise to other UCPG and UCM business units as needed. Works closely with the Coding Education team to suggest opportunities for coder and provider training.
Assists clinical departments in resolving escalated AR and denial issues. Works with Hospital Billing (HB) team on AR issues that cross between PB, HB, or SBO applications.
Ability to provide AR Follow-up training to existing and new AR Follow-up staff.
Ability to complete quality audits for denial and AR resolution activities.
Ability to create denial Appeal, Reconsideration, and Letter of Medical Necessity Letter templates and trains staff in effectively using these templates.
Ability to create workflows and assists manager in developing and documenting policies and procedures.
Proven ability to effectively develop and introduce procedures and processes to others both within Department and with Manager/individuals in other UCM departments is; required.
Demonstrated ability to participate as a member of a work group or team is; required.
Demonstrated ability to set priorities and to effectively manage completion of assigned duties, with minimal supervision is; required.
Demonstrated ability to communicate effectively in English, both orally and in writing is; required.
Education, Experience or Certifications:
Bachelors Degree or 8 years equivalent work experience, required.
Previous experience with physician revenue cycle specific AR Follow-up and denial resolution, required.
Previous experience with diagnosis and CPT coding terminology; required.
Previous experience with charge correction activities; required.
Previous experience using physician billing/revenue cycle software and electronic medical records systems; required
Technical Knowledge or Skills:
Critical thinking skills to review/compare information and form conclusions; required.
PC experience and MS Office (Word, Excel, PowerPoint); required.
Demonstration of effective interpersonal skills necessary to develop effective working relationships with both internal and external customers; required.
Reference Contact Information
NOTE: When applying, all required documents MUST be uploaded under the Resume/CV section of the application
Pay Range: $18.52-$27.12
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Staff Job seekers in need of a reasonable accommodation to complete the application process should call 773-702-5800 or submit a request via the Applicant Inquiry Form.
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