Patient Financial Services Reimbursement Analyst 3

Location: Danbury, CT, United States

Requisition ID: 50827

Salary Range: 20.23 - 37.56 HOURLY

Work Shift: Monday-Friday, 7:00am-3:30pm

FT/PT/PD: Full-Time

Exempt/Non-Exempt: Non-Exempt

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Description

Summary:

Facilitates the revenue cycle from claim submission through claim adjudication. Insures all claims are compliant with State and Federal billing regulations and contractual obligations. Leads and promotes relationships and meetings with third party payers to expedite cash flow. Includes all of the responsibilities of level 2 and provides training and guidance to level 1 and 2 staffs. Authorized to act on behalf of management in their absence

Responsibilities:

1. Provides training and guidance to level 1 & 2 employees. Supports supervisory and management staff. Responsible for Team Lead's activities in their absence. Operates at a higher level with authorization to approve adjustments/discounts and payment arrangements. General authorization for decision-making in the absence of management. 2. Contributes to the design and flow of all processes and procedures within the Patient Financial Services Department and assumes responsibility for the leadership of process improvement and lean six initiatives. 3. Drives financial counseling activities by accurately identifying and documenting financial and payor-specific issues within the system. 4. Responsible for the collection of insurance and patient payments. Requires a high level of decision-making capabilities as well as a complete understanding of payor requirements and state and federal collection laws and regulations. 5. Monitors and tracks timely and compliant claim submissions. Responds to all patient and payer inquiries, denials, correspondence and telephone inquiries and acts as a point of escalation for all identified issues. 6. Confirms electronic and hard-copy billing of all delinquent claims and reports all identified trends to payer and management. Authorized to escalate payor rejection trends tp payor administration. 7. Maintains and monitors all reports, files and records as needed to insure timely and accurate cash-flow. 8. Advises other hospital departments as to billing requirements and payer regulations, including medical necessity and correct coding initiatives. 9. Remains current with education of rules and regulations in the managed care system, as well as State and Federal guidelines. 10. Insures accurate account balances, and is accountable for addressing and reconciling insurance payment discrepancies. Monitors account balances and reports any variances from expected payments to management. 12. Maintains accurate and timely claim submission for designated groups of accounts by payer. 13. Applies cash received to appropriate accounts and refunds all overpayments as indicated by policy. 14. Maintains all departmental policies and procedures. Adheres to all policies and procedures related to compliance with all Federal and State billing and collection regulations and third-party contractual obligations. 15. Answers telephone calls according to established customer service standards. Provides information to callers, answers patient questions and explains the process to ensure effective communication and customer service. Utilizes clear and concise interpersonal skills. 16. Fulfills all compliance responsibilities related to the position. 17. Performs other duties as assigned.

Other Information:

Required: Position requires knowledge of all aspects of responsibilities of the CBO; Basic knowledge of applicable federal, state laws and regulations; well-developed verbal and written communication skills; Excellent analytical and problem solving skills; Strong working knowledge of payor rules and regulations; Knowledge of hospital billing; Demonstrated ability to manage multiple and complex tasks; Demonstrated ability to train and motivate employees; Professional attitude and ability to relate to executive management and patients; Exhibits self-direction, good judgment in handling difficult situations and good organization, time management, interpersonal and conflict resolution skills. Minimum Experience: three years.

Working Conditions:

Manual: significant manual skills/motor coord & finger dexterity

Occupational: Little or no potential for occupational risk

Physical Effort: Sedentary/light effort. May exert up to 10 lbs. force

Physical Environment: Generally pleasant working conditions

Company: Nuvance Health

Org Unit: 1785

Department: Patient Accounting

Exempt: No

Salary Range: $20.23 - $28/hour - BOE and internal equity

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EOE, including disability/vets.

We will endeavor to make a reasonable accommodation to the known physical or mental limitations of a qualified applicant with a disability unless the accommodation would impose an undue hardship on the operation of our business. If you believe you require such assistance to complete this form or to participate in an interview, please contact Human Resources at 203-739-7330 (for reasonable accommodation requests only). Please provide all information requested to assure that you are considered for current or future opportunities.