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Revenue Cycle Financial Analyst

2 months ago

Oxnard, California, United States CommonSpirit Health Full time

Position Overview:

CommonSpirit Health is a leading not-for-profit healthcare organization dedicated to providing high-quality care across its extensive network. We are currently seeking a dedicated and detail-oriented Revenue Cycle Financial Analyst to enhance our team. This position is essential in refining our revenue cycle operations, ensuring prompt and precise reimbursement from various insurance providers.

Key Responsibilities:

  • Regularly assesses both unbilled and billed accounts to evaluate anticipated reimbursements and identify potential obstacles to achieving complete reimbursement.
  • Conducts monthly audits and analyses of denied claims, identifying challenges and proposing actionable solutions.
  • Reviews high-value reports, analyzing expected reimbursements on a daily and weekly basis, and prepares consistent reporting for management.
  • Evaluates the efficiency and accuracy of each stage in the processing of selected accounts, including but not limited to:
    • Notification of relevant departments regarding patient admissions,
    • Pre-admission screening and confirmation,
    • Post-admission verification and requirements,
    • Compliance with certification requirements,
    • Receipt of necessary authorizations,
    • Submission and receipt of ancillary department reports,
    • Claim submissions,
    • Analysis of causes and solutions for returned claims.

Qualifications:

  • High School Diploma or GED required.
  • Associate's Degree preferred.
  • A minimum of 5 years of experience in Patient Accounting, Patient Financial Services, or Admissions is required.
  • Familiarity with government regulations and commercial contracts is essential.
  • Comprehensive knowledge of regulatory requirements and commercial agreements is necessary.