Description
Job Summary
The primary functions of the PFS Payor analyst include hospital/facility billing reimbursement analysis, system/process development, problem resolution and workflow oversight.
Specifically:
Perform analysis and problem solving of issues/problems without precedent and/or structure
Provide detailed analysis and reporting of contract payor performance to include payment trends, denials, delinquencies and payment variances from expected reimbursement
Identify and track issues related to expected reimbursement vs payment discrepancies to maximize revenue and increase efficiency
Work with internal and external departments to formulate strategies and administer policies, processes, and resources
Ensure account information contains accurate and comprehensive data to provide timely billing and optimal reimbursement for services
Review processes including authorization, registration, charge capture, coding, insurance identification, data entry, billing, contract management, payment posting, refund processing, and collections
Act as the department liaison for Contract Management system development and operation
Maintain contract profiles in EPIC and/or vendor system. Conducts extensive testing before contract profiles are deployed to the production environment.
This is a hybrid (remote & onsite) position.
Apply By Date
7/12/2024 @ 11:59pm
Qualifications
Minimum Qualifications
For full consideration applicants are encouraged to upload license and certification if required of the position.
- Bachelor's degree in related area and/or equivalent experience
- Academic institution or large integrated health system experience
- Knowledge of hospital/facility billing and reimbursement procedures, for Commercial/Managed Care and Government payors and the ability to recognize when procedures are not being followed; experience with contracts as it pertains to division of financial responsibility and evaluating billing and reimbursement terms
- Experience working with revenue cycle information systems or system implementation teams for complex projects, application development and/or support
- Hospital/facility billing and accounts receivable experience
- In-depth knowledge of the healthcare revenue cycle's practices, procedures, concepts, and component operations, including billing, collections, contractual terms, third-party reimbursements, and cash management
- Intermediate to advanced use of data mining software applications, including Microsoft Excel, and the ability to create Executive-level reporting in PowerPoint and Word
- Experience with Clearinghouse, Contract Management, and Patient Accounting systems
- Strong experience advising management, serving as a technical leader, providing proposals for improvement and guidance on regulatory changes and industry trends and developments in revenue cycle management
- Advanced communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner
- Intermediate level of operations and contract knowledge
- Billing and accounts receivable experience
- Intermediate skills in report development and various software tools specific to healthcare revenue cycle management
- Experience with Contract Management and Patient Accounting systems
- Strong organizational and project management skills, and ability to lead a team, prioritize tasks, and see projects through from inception to completion on schedule
- Strong skills in report development, dashboard design, and various software tools specific to healthcare revenue cycle management. Skills in common database, spreadsheet and presentation software
Preferred Qualifications
- Experience using tools such as Slicer and Tableau
- Experience building and maintaining contracts in EPIC Contracts
Key Responsibilities
- 40% - Analysis and Reporting
- 40% - Quality Control
- 15% - Planning
- 5% - Special Projects/Other Duties as Assigned
Department Overview
Patient Financial Services (PFS) manages revenue cycle functions including DNFB, billing, contract management, insurance follow-up, charge audit, denials, underpayments as well as internal operational and functional reporting and support related to hospital/facility billing.
Department Specific Job Scope
Patient Financial Services (PFS) manages revenue cycle functions including DNFB, billing, contract management, insurance follow-up, charge audit, denials, underpayments as well as internal operational and functional reporting and support related to hospital/facility billing. PFS ensures account information contains accurate and comprehensive data to provide timely billing and optimal reimbursement for services rendered. PFS impacts processes to include charge capture, coding, insurance identification, data/charge entry, registration, authorizations, billing, payment posting, refund processing and collections.
POSITION INFORMATION
- Salary or Pay Range: $2,770.40 - $5,023.20
- Salary Frequency: Biweekly
- Salary Grade: Grade 22
- UC Job Title: REVENUE CYCLE HC ANL 3
- Number of Positions: 1
- Appointment Type: Staff: Career
- Percentage of Time: 100
- Shift Hours: Day, 8 hours
- Location: UCDHAS Building (HSP165)
- Union Representation: 99 - Non-Represented (PPSM)
- Benefits Eligible:
- Hybrid/Remote/Onsite: This position is hybrid (mix of on-site and remote work)
· THIS IS NOT AN H1- B OPPORTUNITY
Benefits
Outstanding benefits and perks are among the many rewards of working for the University of California. UC Davis offers a full range of benefits, resources and programs to help you bring your best self to work, as well as to help you and your family achieve your health, wellness, financial and career goals. Learn more about the benefits below and eligibility rules by visiting either our handy Benefits Summary for UC Davis Health Employees or Benefits Summary for UC Davis Employees and our Benefits Page.
If you are represented by a union, benefits are negotiated between the University of California (UC) and your union and finalized in a contract. Read your bargaining unit's employment contract, stay abreast of current negotiations and learn about collective bargaining at UC: https://ucnet.universityofcalifornia.edu/labor/bargaining-units/index.html
• High quality and low-cost medical plans to choose from to fit your family's needs
• UC pays for Dental and Vision insurance premiums for you and your family
• Extensive leave benefits including Pregnancy and Parental Leave, Family & Medical Leave
• Paid Holidays annually as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
• Paid Time Off/Vacation/Sick Time as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
• Continuing Education (CE) allowance and Education Reimbursement Program as stipulated in the UC Davis Health Policies or Collective Bargaining Agreement
• Access to free professional development courses and learning opportunities for personal and professional growth
• WorkLife and Wellness programs and resources
• On-site Employee Assistance Program including access to free mental health services
• Supplemental insurance offered including additional life, short/long term disability, pet insurance and legal coverage
• Public Service Loan Forgiveness (PSFL) Qualified Employer & Student Loan Repayment Assistance Program for qualified roles
• Retirement benefit options for eligible roles including Pension and other Retirement Saving Plans. More information on our retirement benefits can be found here
• UC Davis cares about building a community, which is why we provide resources to enhance diversity, equity and inclusion as well as Employee Resource Groups (ERGs) to support our staff
Physical Demands
- Standing - Occasional Up to 3 Hours
- Walking - Occasional Up to 3 Hours
- Sitting - Continuous 6 to 8+ Hours
- Lifting/Carrying 0-25 Lbs - Occasional Up to 3 Hours
- Lifting/Carrying 26-50 lbs - Never 0 Hours
- Lifting/Carrying over 50 lbs - Never 0 Hours
- Pushing/Pulling 0-25 Lbs - Occasional Up to 3 Hours
- Pushing/Pulling 26-50 lbs - Never 0 Hours
- Pushing/Pulling over 50 lbs - Never 0 Hours
- Bending/Stooping - Occasional Up to 3 Hours
- Squatting/Kneeling - Occasional Up to 3 Hours
- Twisting - Occasional Up to 3 Hours
- Climbing (e.g., stairs or ladders) - Never 0 Hours
- Reaching overhead - Occasional Up to 3 Hours
- Keyboard use/repetitive motion - Continuous 6 to 8+ Hours
Environmental Demands
- Chemicals, dust, gases, or fumes - Never 0 Hours
- Loud noise levels - Never 0 Hours
- Marked changes in humidity or temperature - Never 0 Hours
- Microwave/Radiation - Never 0 Hours
- Operating motor vehicles and/or equipment - Never 0 Hours
- Extreme Temperatures - Never 0 Hours
- Uneven Surfaces or Elevations - Never 0 Hours
Mental Demands
- Sustained attention and concentration - Continuous 6 to 8+ Hours
- Complex problem solving/reasoning - Continuous 6 to 8+ Hours
- Ability to organize & prioritize - Continuous 6 to 8+ Hours
- Communication skills - Continuous 6 to 8+ Hours
- Numerical skills - Continuous 6 to 8+ Hours
- Constant Interaction - Frequent 3 to 6 Hours
- Customer/Patient Contact - Occasional Up to 3 Hours
- Multiple Concurrent Tasks - Continuous 6 to 8+ Hours
Work Environment
Must be able to work occasional overtime and/or flexible hours as needed
Special Requirements
- This is a critical position, as defined by UC policy and local procedures, and as such, employment is contingent upon successful completion of background check(s), including but not limited to criminal record history background check(s)
- This position is designated as a mandated reporter under CANRA and UC policy, and employment is contingent on compliance with applicable policies, procedures and training requirements
Diversity, Equity, Inclusion and Belonging
At UC Davis, we're solving life's most urgent challenges to bring a fuller, healthier, and more resilient world within reach. We grow from every challenge we take on and we don't just maintain - we improve. We recognize that creating an inclusive and intellectually vibrant organization means understanding and valuing both our individual differences and our common ground. The most comprehensive solutions come from the most diverse minds and you belong here. As you consider joining UC Davis, please explore our Principles of Community, our Clinical Strategic Plan and strategic vision for research and education, and our latest efforts to outgrow the expected. The University of California, Davis is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, age or protected veteran status.
For the University of California's Affirmative Action Policy, please visit: https://policy.ucop.edu/doc/4010393/PPSM-20
For the University of California's Anti-Discrimination Policy, please visit: https://policy.ucop.edu/doc/1001004/Anti-Discrimination
Because we want you to be seen, our recruiting process at UC Davis fosters authenticity, diversity, and inclusion. Studies have shown that some people may not apply to jobs unless they meet every single qualification. Each unique role at UC Davis has a set of requirements and you could be perfect for this role, or you could be perfect for the next role! Don't meet all the requirements? We still encourage you to apply! #YouBelongHere
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