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Junior Revenue Cycle Analyst

  • Requisition no: 503879
  • Work type: Full Time
  • Location: Other US Locations
  • School/Department: Faculty Practice Organization
  • Grade: Grade 104
  • Categories: Administrative Support, General Administration
  • Job Type: Officer of Administration --
  • Bargaining Unit:
  • Regular/Temporary: Regular
  • End Date if Temporary:
  • Hours Per Week: 35
  • Salary Range: Commensurate with experience
 

Position Summary

The Junior Revenue Cycle Analyst (Underpayments) is primarily responsible for identifying reimbursement discrepancies, resolving root cause and submitting appeals to insurance carriers for correct payment. The Junior Revenue Cycle Analyst will provide analytic support, problem solving and communication with Healthcare payers, clinical departments, contracting office and other management.


Responsibilities

  • Reviews paid claims to identify instances of under payments in accordance with contracted reimbursement.
  • Utilize contract management tools such as Experian to identify under-allowed claims for bulk appeals.
  • Reviews and analyzes “Explanation of Benefits” (EOBs) to identify under-allowed claims.
  • Validates findings of underpayment to confirm provider and location credentialing.
  • Verifies applicable contract by, as dictated by operational procedures: reviewing EOB messages and verifying member information for managed care plans.
  • Uses feedback and experience to refine communication skills and tools for use in preparing written and telephone appeals.
  • Compiles and batches appeals by payer, issue, or other pertinent criteria for expedited re-processing of claims.
  • Performs routine follow up and escalate as required.
  • Prepares monthly performance statistics regarding appeals and recoveries.  Perform analysis and identify corrective action plans to address root issues.
  • Monitors and tracks contractual, billing, registration, and posting errors, and provides continuous feedback to management team.
  • Provides feedback to CRO management and Departments in the coordination of projects and activities.
  • Participates in meetings to discuss ongoing trends and issues regarding the administration of managed care contracts.
  • Participates in professional development efforts to be current in managed care reimbursement trends.
  • Represents the CRO on committees, task forces and work groups. 
  • Keeps apprised of rules and regulations affecting reimbursement.  Stays current through appropriate journals and personal contacts of such developments in the industry as may increase the effectiveness of operations.
  • Performs other revenue cycle duties and responsibilities as assigned by the Directors of the CRO.
  • Conforms to all applicable HIPPA, Billing Compliance and safety policies and guidelines.

Minimum Qualifications

  • BA/BS in Business Administration, Health Services Administration (or in a related field) or equivalent work experience.
  • Minimum of 3 years’ related experience.
  • Demonstrated strong skills in problem assessment, and resolution and collaborative problem solving in complex, interdisciplinary settings.
  • Excellent analytical skills: attention to detail, critical thinking ability, decision making, and researching skills in order to analyze a question or problem and reach a solution.
  • Ability to work collaboratively with a culturally diverse staff and patient/family population, strong customer service skills, demonstrating tact and sensitivity in stressful situations.
  • Knowledge of electronic billing systems; knowledge of office machines, including personal computers, and an ability and willingness to learn new systems and programs. 
  • Demonstrated proficiency in health insurance billing, collections, and eligibility as it pertains to commercial and managed care, and self-pay reimbursement concepts and overall operational impact.
  • Ability to work independently and follow-through and handle multiple tasks simultaneously.
  • Good verbal and written communication skills.
  • Must be a motivated individual with a positive and exceptional work ethic.
  • Intermediate to advanced working proficiency of Microsoft Office (Word & Excel) or similar software is required.
  • Must successfully complete systems training requirements.

Preferred Qualifications

  • Knowledge of Experian contract management software is preferred.

Other Requirements

  • Core Competencies:

    Preferred Minimum Proficiency Level

    Accountability & Self-Management

    Level 3 - Intermediate

    Adaptability to Change

    Level 2 - Basic

    Communication

    Level 2 - Basic

    Customer Service-Patient Focus

    Level 3 - Intermediate

    Emotional Intelligence

    Level 2 - Basic

    Problem Solving & Decision Making

    Level 3 - Intermediate

    Productivity & Time Management

    Level 3 - Intermediate

    Teamwork & Collaboration

    Level 2 - Basic

    Quality & Compliance Focused

    Level 3 - Intermediate

    Leadership Competencies:

    Preferred Minimum Proficiency Level

    Performance Management

    Level 2 - Basic


Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.

Applications open: Eastern Daylight Time
Applications close:

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