Business analyst Jobs in Plano tx

About the Role

Impact you will make

A Revenue Opportunity Business Operations Analyst within Government Reimbursement will analyze and recommend solutions to Revenue Opportunity business problems. The Analyst's primary responsibility will include completing all necessary research to identify claims eligible for adjustment and / or original billing. Business Operations Analysts will need a high-level understanding within the industry and recognize FinThrive's acceptable quality standards as well as effectively communicate internally to ensure the highest standard of experience for our customers.

What you will do

• Ability to create projects in Government Reimbursement Manager
• Utilize Medicare Administrative Contractor (MAC) portals to complete Medicare Beneficiary Identifier (MBI) research
• Process projects through Revenue Opportunity Manager
• Preview return results to ensure projects have processed successful through Medicare Common Working File and HIPAA Eligibility Transaction System (HETS)
• Recognize discrepancies between current project and previous projects and alert leadership for further research
• Identify accounts within Government Reimbursement Manager that require research
• Research via MAC Interactive Voice Response (IVR) and / or Web Portal to identify potential reimbursable claims
• Contact Home Health Agencies and Skilled Nursing Facilities to verify level of patient care
• Review of patient medical records to identify transfers and receiving facility information
• Rebill accounts through Medicare Direct Data Entry (DDE) System
• Monitor claims returned or rejected to guarantee prompt correction and resolution
• Scrape Medicare DDE to identify payments, return to provider claims (RTP) and rejected claims
• Execute existing SQL queries to create monthly logs for Medicare Advantage patients
• Use CMS tools (pricer) to complete estimated additional reimbursements for eligible claims
• Establish and maintain login credentials for Medicare systems used by colleagues

What you will bring

What we would like to see

About FinThrive

FinThrive is advancing the healthcare economy.

For the most recent information on FinThrive's vision for healthcare revenue management visit finthrive.com / why-finthrive .

Award-winning Culture of Customer-centricity and Reliability

At FinThrive we're proud of our agile and committed culture, which makes FinThrive an exceptional place to work. Explore our latest workplace recognitions at https : / / finthrive.com / careers#culture .

Our Perks and Benefits

FinThrive is committed to continually enhancing the colleague experience by actively seeking new perks and benefits. For the most up-to-date offerings visit finthrive.com / careers-benefits .

FinThrive's Core Values and Expectations

Physical Demands

The physical demands and work environment characteristics described here are representative of those that a colleague must meet to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

Statement of EEO

FinThrive values diversity and belonging and is proud to be an Equal Employment Opportunity employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status. We're committed to providing reasonable accommodation for qualified applicants with disabilities in our job application and recruitment process.

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FinThrive is an Equal Opportunity Employer and ensures its employment decisions comply with principles embodied in Title VII, the Age Discrimination in Employment Act, the Rehabilitation Act of 1973, the Vietnam Veterans Readjustment Assistance Act of 1974, Executive Order 11246, Revised Order Number 4, and applicable state regulations.

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