The Denials Analyst with the Revenue Cycle team will collect, review, and report on data. Identify trends/problems, recommend and create resolution and provide education to senior leaders and associates on new processes and resources to prevent denials on the front-end.
â¢ Leverages in-depth knowledge of business practices to identify and problem-solve anomalies, including trouble-shooting, root cause analysis, design and implementation of solutions.
â¢ Prepare, compile, distribute and analyze regular reports of denials and the impact of continuous errors (both technical and coding) on revenue collection.
â¢ Communicate effectively with site and system leadership. Prepare, interpret data, and present Power Point Presentations on a regular basis to associates , clinical staff, and system leadership.
â¢ Initiate proactive communications with payer and facilities to obtain maximum reimbursement, meet monthly with RC teams and site teams to resolve billing and coding issues and to present educational opportunities.
â¢ Assist program directors and revenue service managers in coordinating revenue optimization through correct demographic collection, billing and/or coding practices.
â¢ Responsible for managing scope and completion of work, meeting deadlines, and providing deliverables to the customers or end users. Coordinates projects, participates in meetings as necessary to complete assignments.
3+ years relevant experience in a healthcare setting
Intermediate to advanced knowledge of Excel (Pivot tables, Vlookups, formulas) and Power Point
Experience with trending, root cause analysis and recommending process improvement initiatives
Excellent communication and presentation skills
Highly prefer experience with commercial and government payors/experience with the medical billing process
One year of Performance Improvement experience (Lean, 6Sigma, Agile)
Knowledge of RAC and other state/federal billing audit programs.
Knowledge of change management principles and process improvement methods.
SCL Health is a faith-based, nonprofit healthcare organization that operates eight hospitals, four safety net clinics, one children’s mental health center and more than 190 ambulatory service centers in three states – Colorado, Kansas and Montana. The health system includes 15,000 full-time associates and more than 500 employed providers.