Business Operations Analyst

Presbyterian Healthcare Services•Rio Rancho, NM

1d•$50,482 - $85,966•Onsite

About The Position

Build Your Career. Make a Difference. We are seeking a skilled Business Operations Analyst. In direct coordination with the Revenue Management Department performs the following functions - Proactive daily audits of patient billing. Identifies, determines and executes on actions for discrepancies. Initiates the billing processes for administration (procedures), drugs and equipment used in the care of patients. Responsible for identifying and facilitating CDM adjustments in response to Medicare, 3rd party and other payer regulations and ensuring compliant CPT4, ICD9 and HCPCS coding Monitor changes in the Federal Register relating to reimbursement of services/products provided. Maintain financial health of this service.

Requirements

Associates Degree, Diploma in business, or three to five years experience in a healthcare reimbursement/business office environment

Responsibilities

Directs data acquisition by coordination with individual area members. Assessment of gathered data is to be used to produce area measurements, quality statistics and area improvement effort.
Manage change: change initiatives, educate and prepare staff accordingly.
Provides input into the development budget, departmental goals and objectives, policies and procedures and assists in ensuring the department operates within budget.
Counsels patients on financial responsibilities and costs of various treatment options and sets up payment plans as necessary.
Maintains and fosters effective public relations with patients, physicians and the public.
Coordinates directly with the Central Business Office and Revenue Management Department to ensure compliance with third party payers and regulations.
Keeps current with developments in the field of medical oncology through participation in seminars, workshops and publications.
Oversees and maintains follow-up procedures to ensure billing on a timely basis.
Reviews problem bills to determine causative agent for and resolution of problems, takes appropriate action for rebilling or corrections via direct coordination with the Central Business Office and Revenue Management Department.
Review incomplete Medical Record Reports for any patients that are lacking required documentation to ensure compliance with PHS and Medicare policy.
Audit patient accounts for billing errors; research errors found and intervene if necessary in making corrections via direct coordination with the Central Business Office and Revenue Management Department.
Maintain current knowledge of all reimbursement/ billing practices of third party and private insurance payers.
Regularly evaluate changes/updates of FDA approval of drugs and treatments to ensure proper reimbursement.
Maintain appropriate billing procedures, ensuring that the accounts receivable records are kept in accordance with established procedures.
Assemble, prepare, and distribute relevant information to the appropriate individual(s) to facilitate further processing.