Revenue Cycle Analyst - 111685
As a federally-funded institution, UC San Diego Health maintains a marijuana and drug free campus. New employees are subject to drug screening.
#111685 Revenue Cycle AnalystInitial Review Date: Wed 1/12/2022
For the safety and well-being of the entire university community, the University of California requires, with few exceptions, that all students, faculty and staff be vaccinated against the COVID-19 virus and influenza before they will be allowed on campus or in a facility or office. For more information visit: Flu Vaccine Mandate / COVID Vaccine Policy
UCSD Layoff from Career Appointment: Apply by 09/20/21 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 09/30/21. Eligible Special Selection clients should contact their Disability Counselor for assistance.
This position will remain open until filled.
Involves revenue cycle functions for the healthcare enterprise, including system billing, reporting, and follow-up for non-payment and underpayment. Ensures account information contains accurate and comprehensive data to provide timely billing and optimal reimbursement for services. Impacts processes to include charge capture, coding, insurance identification, data entry, billing, payment posting, refund processing and collections. May also be responsible for / integrated with business office operations.
Responsible for the full range of third party billing duties. Extensive knowledge of medical insurance and State and Federal rules and regulations related to billing Insurance Claims. Extensive knowledge in Insurance claims appeals and payer contracts, and range of knowledge in ICD9, ICD10, CPT, HCPCS, coding principles. Knowledge of medical/surgical terminology. Knowledge of accounting and cash handling principles and various billing documents and claim forms. Responds to billing inquiries from patients, insurance companies and departments. Identifies and resolves issues regarding account adjustments, rebilling insurance, and/or collecting from patients as appropriate. Job is to be performed at the EXPERT level. Other related duties as assigned.
- Under general supervision, applies dashboards and processes for continuous analysis of revenue cycle functions of moderate scope and complexity. Audits data input for all components of revenue cycle management.
- Applies acquired skills to collaborate in gathering data, identifying trends, and performing financial analyses of revenue cycle operations.
- Assists departments with defining reporting and information requirements. Assists with identifying data sources, develops and delivers routine and ado reports and presentations.
- Under general supervision, works proactively with assigned departments to assure appropriate revenue cycle practices and compliance with internal and external regulations.
- Contributes to small to medium projects analyzing revenue cycle workflows to propose improvements in efficiencies and timeliness. Assists in developing workflow improvements to maximize revenues.
- Under supervision, analyzes charge integrity, reconciliation and charge linkages from ancillary charging systems for the medical center / health system.
- Delivers training to patient financial services units on revenue cycle systems, processes and procedures. Patient finance areas include registration, insurance
- Accurately calculates underpayments and actively pursues insurance companies for full payment. Identifies underpayment trends and escalates them to leadership.
- Implements new processes for managing the pursuit of unpaid or underpaid bills or claims; identifies gaps in workflows. Trains staff on changes to systems or procedures.
- Work with leadership to implement improved workflows for various revenue cycle processes including but not limited to coverage updates, provider-level adjustments, etc.
Six (6) years of related experience, education/training in payor contract interpretation and analysis, appeal process, government policy and regulations in Healthcare field OR a Bachelor’s degree in related area plus two (2) years of related experience/training in payor contract interpretation and analysis, appeal process, government policy and regulations in Healthcare field.
Working knowledge of reporting instruments, metrics and/or dashboard design
Detail oriented, with demonstrated organizational skills and the ability to manage time efficiently, prioritize tasks, set schedules, and complete projects in a timely and cost-effective manner.
Proficiency in common database, spreadsheet and presentation software.
Strong communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to summarize and present reports and presentations.
Excellent analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems.
Effective interpersonal skills to work effectively in a team environment with internal staff in a wide
- Experience in a healthcare environment is preferred.
- Must be able to work various hours and locations based on business needs.
- Employment is subject to a criminal background check and pre-employment physical.
Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and and dozens of outpatient clinics. We invite you to join our team!
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