Yale New Haven Health System

  • RECEIVABLE INTEGRITY QA REPORTING ANALYST

    Job Locations US-CT-New Haven
    Job ID
    66130
    Department
    RECEIVABLE INTEGRITY
    Category
    INFORMATION TECHNOLOGY
    Position Type
    Full Time Benefits Eligible
    Scheduled Hours
    40
    Work Schedule
    DAYS
    Work Days
    MON - FRI
    Work Hours
    7:30AM - 4:30PM (FLEX)
    Work Shift
    ADDITIONAL HOURS MAY BE REQUIRED ON A PERIODIC BASIS
    Requisition ID
    2018-19400
  • Overview

    To be part of our organization, every employee should understand and share in the YNHHS Vision, support our Mission, and live our Values. These values—integrity, patient-centered, respect, accountability, and compassion—must guide what we do, as individuals and professionals, every day.

    Reports to the Director, Financial Services, SBO with responsibility for supporting the analysis and identification of areas of exposure relating to compliance with regulatory requirements / internal operational procedures within the System Business Office, Access Management and HIM across entities. Assists operational areas in providing patient level detail in support of regulatory compliance activities. As requested by the Director, evaluates governmental reimbursement proposals for purposes of determining implications on revenue cycle initiatives. Develops data mining reports to support departmental operations. With use of the various systems, reviews and reports on third party payer audits, either retrospective or concurrent reviews regarding issues as they relate to revenue cycle. Develops databases which allow end users to create reports and extract data utilizing business intelligence solutions. Acts as the liaison between the SBO / Access / HIM and the EPIC IT team to ensure operational needs are met through the build out of the Business Objects Universe and third party reporting tool. Assists in the monitoring, tracking and reporting of revenue cycle initiatives. Assigned to accounts receivables special projects as designated by the Director.

    EEO/AA/Disability/Veteran

    Responsibilities

    • 1. Provides general technical guidance and assists in global design, and detailed creation of complex reporting requests. Coordinates with Patient Account Systems Department as well as with SBO super users in the strategy formulation.
    • 2. Researches and recommends use of specific techniques, languages and methodologies as they impact the development of the department's data mining capabilities. Provides feedback and recommendations for reporting alternatives.
    • 3. Assists in establishing and instituting effective procedures to minimize financial risk at each entity through innovative and detailed reporting.
    • 4. Supports all third party payer audits and the denial team by developing reporting regarding additional reimbursements due for disputed claims and denials that were appealed .
    • 5. Develops and maintains repository of data related to outsource vendor account inventories. Also develops detailed algorithms for placement identification purposes.
    • 6. Coordinates the incorporation of external data into existing data schemas and determines reporting distribution strategy.
    • 7. Maintain regular communication with Regulatory / Operational Reporting Specialist, Epic and ITS representatives regarding business intelligence initiatives.
    • 8. In conjunction with Business Practice auditors and Quality Assurance team, assist in monthly Quality Assurance reviews for the SBO. Performs data mining relative to the identification of potential Quality Assurance issues.
    • 9. Identifies areas of exposures relating to compliance with internal operational procedures as well as participating in related audit review with Compliance. Performs quality assurance functions, as required.
    • 10. Assists with training for managers, supervisors and end-users on new reporting tools. Assists in the development of procedural, technical and user manuals designed to aid in the use of reporting tools ensuring that users are properly educated and trained.
    • 11. Prepares daily, weekly, monthly and/or quarterly reports of variations on contractual amounts expected versus actual payments utilizing the current account receivable systems and other PC software programs. Regularly summarizes data at an executive level.
    • *cb

    Qualifications

    EDUCATION

     

    (number of years and type required to perform the position duties): Bachelor's degree in a related field required.

     

    EXPERIENCE

     

    number of years and type required to meet an acceptable level of performance): 2 to 4 years of experience in healthcare revenue cycle environment from a payer and/or payee perspective with at least 2 years systems analysis and programming activities.

     

    SPECIAL SKILLS

     

    Demonstrated experience working with an SQL enterprise level database and developing, maintaining and programming complex queries. Familiarity with third party reporting tools such as Crystal reports and Business Objects. Prior experience in the analysis, design, development and support of dashboards, score cards and end user reports. Ability to meet deadlines with minimal supervision Strong organizational, problem solving and listening skills, and attention to detail,. Must possess a high level of customer service skills and participate as strong collaborative team player.

     

    Options

    Sorry the Share function is not working properly at this moment. Please refresh the page and try again later.
    Share on your newsfeed

    Connect With Us!

    Not ready to apply? Connect with us for general consideration.