Job Description

JOB SUMMARY
System Denials Analyst analyzes all denials, write offs, and adjustments to identify net positive impactful opportunities at a facility and System-wide level that supports a focused response. The Analyst will communicate high dollar single opportunities as well as actionable trending to either specific facilities or across the System depending on the scope of the finding. The Analyst will maintain standardized reporting in centralized locations for all stakeholders in the process, as well as provide ad hoc reporting and data mining as findings dictate.

Requirements:

DUTIES AND RESPONSIBILITIES

PEOPLE - 30%

Communicates openly in a transparent and professional demeanor during all interactions with customers and co-workers.
Provides clear and concise communication of trending and findings to both front line team members and senior executives.
Demonstrates the components of the ICARE values statement.
Communicates in a time efficient and effective manner
Provides proactive updates on initiatives that involve time and effort from peers and other employees.

FINANCE - 20%

Communicates high dollar single opportunities as well as actionable trending to either specific facilities or across the System depending on the scope of the finding.
Participates in departmental and hospital performance improvement plan
Prioritizes opportunity for stakeholders based on financial benefit.

QUALITY/SAFETY - 10%

Completes monthly reporting accurately and timely in support of appropriate organizational response.
Reports accidents promptly and corrects minor safety hazards.
Complies with applicable laws, regulations, guidelines and standards regarding safety and infection control issues.
Follows all safety rules while on the job.

SERVICE - 30%

Performs data mining and reporting activities that identify net positive impactful opportunities in denials and adjustments for the individual facilities and the System. (daily)
Performs detailed reimbursement analyses independently and formulates appropriate modes of communication depending on the target population (regular activity)
Compiles and distributes denials and adjustment trending summaries to all stakeholders (weekly)
Schedules and maintains monthly taskforce appointments and attendee lists (regular activity)
Creates Denials Taskforce Meeting agendas (weekly)
Attends all business office and hospital based task force meetings (weekly)
Records minutes from task force meetings, including next steps and ownership (weekly)
Distributes summary of action items System-wide (monthly)
Ensures consistency of task force approach System-wide (weekly)
Acts as a liaison for issues affecting multiple hospitals to coordinate action items (daily)
Provides support when IT related or systematic changes are needed (regularly)
Owns System-wide Denials Tracker, ensures action items are updated timely (weekly)
Measures success of task force by trending denials data for resolved issues (weekly)