Revenue Cycle Business Analyst - Hybrid/Remote - 123000

#123000 Revenue Cycle Business Analyst - Hybrid/Remote

Filing Deadline: Thu 5/18/2023

UC San Diego values equity, diversity, and inclusion. If you are interested in being part of our team, possess the needed licensure and certifications, and feel that you have most of the qualifications and/or transferable skills for a job opening, we strongly encourage you to apply.

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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.
UCSD Layoff from Career Appointment: Apply by 05/08/23 for consideration with preference for rehire. All layoff applicants should contact their Employment Advisor.
Special Selection Applicants: Apply by 5/18/23. Eligible Special Selection clients should contact their Disability Counselor for assistance.
This position will work a hybrid schedule which includes a combination of working both onsite at Greenwich Drive and remote.
Description
UC San Diego Health's Revenue Cycle department supports the organization's mission to deliver outstanding patient care and to create a healthier world - one life at a time. We are a diverse, patient-focused, high-performing team with a commitment to quality, collaboration, and continuous improvement that enables us to deliver the maximum standard of care to our patients. We offer challenging career opportunities in a fast-paced and innovative environment and we embrace individuals who demonstrate a deep passion for problem-solving and customer service.
Reporting to the Manager of Business Analytics, the Revenue Cycle Business Analyst will play a key role in supporting the efforts of senior leadership by providing sound insight and guidance from a financial data and reporting perspective. Encompassing both Professional and Hospital Billing, the successful candidate will exist in a hybrid role functioning as a revenue cycle subject matter expert and serve as a key liaison between clinical administration and the different functional areas of the revenue cycle operation.
Core competencies for this senior level role will include but not limited to the following:
Reporting
The ability to provide first rate analytical support with advanced proficiency in SQL, BI Tools, excel skills, and flow charting software. Hands-on experience in statistical analysis, data-mining, quantitative financial research required; develop effective statistical models for segmentation, classification, and optimization. A sound understanding of relational databases and ability to scope and self-service extracts based on common fields and table joins via primary & secondary keys. Strong modeling and presentation skills, experience and comfort with statistical modeling packages, and comfort with large data sets.
Revenue Cycle Management
As a member of the Continuous Improvement team, the Business Analyst will have oversight of revenue cycle performance metrics and be responsible for the development and delivery of effective reporting and complex analytical solutions in support of these measures. Experience must include all functions within scope of the revenue cycle operation; patient access, charge capture, coding, patient billing, collections and customer service.
Demonstrates a proven ability to independently interpret challenges faced by management and correlate into the development of meaningful analyses that can be used to assess operational performance. Apply problem analysis and resolution principles; establish situation response guidelines and take appropriate actions toward resolving revenue cycle concerns/issues with minimal direction. Develop and manage new KPI's and supplemental views to assess charge, payment and adjustment activities, provider productivity and associate care payment transfers, payor adjudication windows, denials inventory, Bad Debt and AR.
The incumbent will serve in a consultative role of workflow assessment and identify process inefficiencies by reporting on trends in reimbursement and denials. Will then correlate trend interpretations with an action plan toward resolution for approval from Revenue Cycle Leadership. Drive business process improvement by indicating recommendations to existing workflows and report development wherever possible; continuously identify processes to automate/eliminate waste, duplicated effort. Proven knowledge of government and non-government payor requirements, industry reimbursement rules, laws and regulations that govern billing/collection activities. Demonstrated knowledge of medical terminology, CPT, ICD-10, HCPCS, modifier codes and including impact on reimbursement, coverage etc.
Business Analysis
The ability to develop key relationships with clinical administration and physician leadership in an effort to support their interpretation and understanding of revenue cycle operations and reporting. Responsible for driving month end performance review summary and developing clear lines of communication through strong presentation of supplemental findings to internal stakeholders and divisional administration. In support of revenue cycle leadership, provide critical information and insight needed to make fact-based decisions and foster strong business relationships providing key internal customers with sound data analyses.
Contracting
Oversight of contract build, development and maintenance functions in EPIC and related financial modeling tied to reimbursement analytics. Paramount to UCSD’s successful adaptation to changes in the payor policy, the resource will be responsible for leveraging remittance, claim and denial detail to provide leadership with sound interpretations of whether payors are interacting in alignment with established contractual language. Additionally, support initiatives tied to systemic build efficiencies, account prioritization (ROI), and underpayment opportunities etc.
Minimum Qualifications

• Experience and proven success in the practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.
• Bachelor's Degree in business, healthcare administration or related area; and/or equivalent experience/training.
• A minimum of five (5+) or more years of relevant experience.

Preferred Qualifications

• Ability to manage ad-hoc reporting initiatives on behalf of operational resources and triage revenue cycle issues toward resolution.
• EPIC (or comparable EMR) super user competencies.
• Transaction based revenue cycle financial literacy, ability to comprehend complex concepts and identify actionable opportunities through reporting and analytical models etc.
• Exposure to contracting module and ability to manage interpretation and build functions.

SPECIAL CONDITIONS

• 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.

Pay Transparency Act
Annual Full Pay Range: $63,400 - $142,800 (will be prorated if the appointment percentage is less than 100%)
Hourly Equivalent: $30.36 - $68.39
Factors in determining the appropriate compensation for a role include experience, skills, knowledge, abilities, education, licensure and certifications, and other business and organizational needs. The Hiring Pay Scale referenced in the job posting is the budgeted salary or hourly range that the University reasonably expects to pay for this position. The Annual Full Pay Range may be broader than what the University anticipates to pay for this position, based on internal equity, budget, and collective bargaining agreements (when applicable).
Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).
If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.
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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