The Ohio State University

Compensation

Full Description

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Job Title: Revenue Cycle Process Improvement Systems Analyst Department: East | Precert and Financial Counseling Scope of Position The Revenue Cycle Process Improvement Systems Analyst serves as an internal consultant supporting and driving implementation of the revenue cycle improvement initiative using a structured industry approved approach. This position is supportive of all revenue cycle process improvement strategic initiatives. Position Summary The Revenue Cycle Process Improvement Systems Analyst is also responsible for a wide variety of functions that primarily revolve around analyzing and resolving issues with accounts that involve authorization, billing, and compliance. This position serves as an expert in understanding the payers’ requirements and works with various other departments to identify issues and resolve them prior to billing or after a denial is received. This position is responsible for providing a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials. This position analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials. The Revenue Cycle Process Improvement Systems Analyst is also responsible for a wide variety of functions that primarily revolve around analyzing and resolving issues with accounts that involve authorization, billing, and compliance. This position serves as an expert in understanding the payers’ requirements and works with various other departments to identify issues and resolve them prior to billing or after a denial is received. This position is responsible for providing a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials. This position analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials. This position uses expert knowledge of payer authorization requirements to write and submit appeals for administrative authorization denials. Identifies and develops appropriate tools to track issues, analyzes workflows, identifies logistical and operational issues to target for improvement. Further, this position is responsible for reviewing accounts with various claim errors that require a second higher-level/comprehensive review. This can include claims with admission or discharge date discrepancies, admission order timing issues, or various other regulatory compliance issues. This position is also responsible for interdepartmental/intradepartmental communication and process improvement throughout the revenue cycle and serve as the primary trainer for onboarding peers with less experience. This position must apply industry knowledge and a thorough understanding of all available systems where revenue cycle information is held, including Midas and EPIC modules for Cadence, ADT, Ambulatory, and Resolute. MINIMUM REQUIRED QUALIFICATIONS Bachelor's degree or equivalent experience. Advanced degree in relevant field may be desirable. 4 years of relevant experience required. 4-8 years of relevant experience preferred. Additional Information: Location: East Hospital - Tower (0397) Position Type: Regular Scheduled Hours: 40 Shift: First Shift Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process. Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions. The university is an equal opportunity employer, including veterans and disability. At Ohio State, you’ll find work that inspires you. We offer roles and growth opportunities in countless fields and specialties — including a job that’s right for you. Ohio State benefits give you options to take care of what matters most to you — and opportunities to make adjustments as your life and needs change, including: • Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost. • Paid time off, including sick and vacation time and 11 holidays. • State retirement plan or an alternative retirement plan, both with generous employer contributions. As Buckeyes, we accomplish more together. No matter your role, you’ll be part of creating what people need now: pathways to education, research and health care. Working at Ohio State means you’re part of a team with a strong sense of community and an unwavering commitment to excellence — and, of course, incomparable Buckeye spirit. We bring out the best in people, help each other succeed and learn together. By joining Ohio State, you become part of a top-20 public university with one of America’s leading academic health centers. We’re a team of dedicated colleagues with access to boundless resources that support you. Review the Frequently Asked Questions for details on using Workday and submitting your application.