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Senior Financial Analyst, Denials

4 months ago

Bristol, United States BRISTOL HOSPITAL GROUP Full time
Job Details

Level
Senior

Job Location
BHI Valley St - Bristol, CT

Position Type
Full Time

Education Level
4 Year Degree

Job Shift
1st Shift (Days)

Job Summary

At Bristol Health, we begin each day caring today for your tomorrow. We have been an integral part of our community for the past 100 years. We are dedicated to providing the best possible care and service to our patients, residents and families. We are committed to provide compassionate, quality care at all times and to uphold our values of Communication, Accountability, Respect and Empathy (C.A.R.E.). We are Magnet ® and received the 2020 Press Ganey Leading Innovator award for our rapid adoption and implementation of healthcare solutions during the COVID-19 pandemic. Use your expertise, compassion, and kindness to transform the patient experience. Make a difference. Make Bristol Health your choice.

Under the direction of the Patient Accounts Manager, the Senior Financial Analyst, Denials is responsible for coordinating hospital wide revenue compliance and revenue enhancement initiatives. With support from key areas throughout the hospital, this position will recommend and coordinate implementation of process improvements for the revenue cycle; educating departments, clinicians and revenue cycle participants on billing and coding regulations and commercial payor policies to ensure compliance to minimize denials.

Responsible for Hospital wide denial management.
  • Coordinates appeals process with appropriate hospital personnel.
  • Reports denial activity monthly including status of appeals and overturn rate.
  • Help to ensure revenue, billing, charging and coding compliance through educating hospital and provider personnel on current and changing regulations.
  • Improve hospital's net revenues, revenue compliance and cash collections by optimizing the hospital wide revenue cycle.
  • Present regulation or policy changes to the Hospital Revenue Cycle Committee on a monthly basis as well as the affected clinical areas.
Contributes to departmental goals and efficient operation of department.
  • Acts in an advisory capacity to Department Heads and others in financial matters.
  • Acts as a resource for billers and financial counselors in billing and authorization issues.
  • Prepares necessary reports analyzing utilization, cost, and reimbursement of various commercial and government payers.
  • Assists in other projects as assigned.


Qualifications

Education/Minimum Requirements

Bachelor's Degree in appropriate discipline (Business Administration, Accounting, Finance) or equivalent experience. One to three years related experience preferred.

State/Federal Mandated Licensure or Certification Requirements:

None

Bristol Hospital Mandated Educational Requirements:

General orientation at time of hire. Fire/Safety/Infection Control annually. Other programs as mandated by Hospital.

Special Requirements:

Familiarity with specialized health care applications as well as Medicare and third party payor appeal and payment processes and policies. Working knowledge of Excel and Word is required. Other decision support system software experience is beneficial.

Physical Requirements:

Extended sitting, together with occasional bending, reaching and stooping.

Work Environment:

Normal office conditions adequate lighting and ventilation. May include customer contact and telephone use.

Cognitive Requirements:

Attention to detail. Good analytical and decision making skills. Good written and verbal communication skills.

Disclaimer

The above statements are intended to describe the general nature and level of work being performed by people assigned to this classification. They are not to be construed as an exhaustive list of all responsibilities, duties, and skills required of personnel so classified. All personnel may be required to perform duties outside of their normal responsibilities from time to time, as needed.