Operations Reconciliation Analyst

Description

Summary :

This position will partner with all Nuvance Health Medical Practices to identify opportunity, and support revenue recovery initiatives and process improvement.

Responsibilities :

1. Manages and analyzes front end reports to quantify and resolve front end edits

2. Serve as a subject matter expert related to charging and billing issues, and assists in developing and maintaining related policies, procedures, and work flows

3. Performs daily reconciliation of professional charges through review of service line schedules, orders, completed physician documentation, and associated charge line items to capture and remediate unbilled charges

4. Provides guidance, communication and education regarding correct charge capture and billing processes to multiple clinical departments and facilities

5. Supports Practice Management through biweekly question and answer sessions

6. Works closely with department managers and operational leaders in addressing front end processes and work queue edits, identifying process improvement opportunities

7. Works closely with Patient Accounting to ensure all billing edits and coding edits are corrected within Revenue Cycle, where applicable

8. Works with Coding Departments, Registration areas and Information Technology Services to ensure proper setup of new service line work queues specific to front end, and billing

9. Partners with the Coding Department upon identification of unbilled surgical charges

10. Manages and remediates Suspended Charges

11. Maintains and Model Nuvance Health Values and Code of Conduct

12. Leads and participates in moderately complex projects related to revenue cycle initiatives

13. Actively participates in all Revenue Cycle related special projects as well as daily, monthly and yearly reporting

14. Stays current with regulatory revisions in payment methodologies via seminars, websites, etc

15. Demonstrates regular, reliable and predictable attendance

16. Maintain and Model Nuvance Health Foundational Values (Personal, Imaginative, Agile, Connected)

17. Performs other duties as required.

Education : BACHELOR'S LVL DGRE

Other Information :

• Bachelor’s Degree or equivalent experience
• Certified Professional Coder (CPC) preferred
• Five (5) years relevant experience in hospital setting, clinic setting, or insurance company with revenue cycle experience
• Detailed oriented
• Proficient in Microsoft Office – specifically Excel and PowerPoint
• Strong analytic aptitude
• Excellent project management skills
• Possesses strong interpersonal communication and presentation skills, effectively presenting information to executives, management, providers, facility groups, and individuals
• Understands expectations of patients, payors, and employees and how those expectations relate to complete, timely, and accurate work products

Certified Professional Coder (CPC) HFMA Certified Revenue Cycle Representative Certification (CRCR) or Certified Healthcare Financial Professional (CHFP) Certification preferred.

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 : 2069

Department : CODERS - PROFESSIONAL & FACILITY CHARGING and CODING

Exempt : Yes

Salary Range : $25.70 - $47.72 Hourly