Denials and Quality Assurance Analyst

Singing River Health System • Pascagoula, MS

5d • Onsite

About The Position

The Denials and Quality Assurance Analyst oversees duties associated with quality efforts relative to registration functions across the health system, including, but not limited to, the analysis and reporting of accuracy rates as well as denial trends with a focus on increased cash flow. He/She monitors and reports Patient Access Services’ key performance indicators. The Denials and Quality Assurance Analyst, in conjunction with department leadership, conducts root cause analyses when issues resulting in increased denials or decreased accuracy/productivity are uncovered. He/She develops and conducts targeted training to address root cause issues and coordinates efforts with other departments as needed at the direction of Patient Access department leadership. The Denials and Quality Assurance Analyst monitors department work queues to identify trends and opportunities for improvement. He/She also maintains the department policy and procedure manual as well as a detailed record of improvement plans and achievements.

Requirements

• High School diploma or equivalent required.
• A minimum of three (3) years’ experience in healthcare registration, patient accounting, or comparable field required.
• Must be recognized as an Epic Credentialed Trainer for Patient Access at (or within six (6) months of) job start.
• Must hold at least one of the following certifications at (or within twelve (12) months of) job start (must complete continuing education to recertify as required by the certifying entity): Certified Revenue Cycle Specialist – Institutional (CRCS-I) or Certified Healthcare Access Associate (CHAA).
• Must have de-escalation training completed by the end of position orientation (90 days); must have appropriate level of de-escalation training.
• Must demonstrate keen mental faculties/assessment and decision making abilities.
• Must demonstrate superior communication/speaking/enunciation skills to receive and give information in person and by telephone.
• Must demonstrate strong written and verbal communication skills.
• Must possess emotional stability conducive to dealing with high stress levels.
• Must demonstrate ability to work under pressure and meet deadlines.
• Attention to detail and the ability to multi-task in complex situations is required.
• Must have the ability to maintain collaborative and respectable working relationships throughout SRHS and other organizations.
• Must possess superior customer service skills and professional etiquette.
• Must possess proficient knowledge and ability to use a computer (must be keyboard proficient) and other office technology (i.e., telephone, fax, etc.), MS Outlook and Word.
• Work requires the ability to function independently, adapt to workload demands, set priorities, and contribute to achieving both individual and departmental goals.
• Must demonstrate a basic understanding of medical terminology as it relates to patient registration.
• Must be able to understand all insurance matters regarding policy benefits, authorization requirements, insurance verification, and contractual allowances.
• Must be able to quickly gain a detailed understanding of complex computerized and non-computerized information.

Nice To Haves

• College courses in healthcare, business, or finance preferred.
• Associate’s degree preferred.

Responsibilities

• Oversees duties associated with quality efforts relative to registration functions across the health system.
• Analyzes and reports accuracy rates and denial trends with a focus on increased cash flow.
• Monitors and reports Patient Access Services’ key performance indicators.
• Conducts root cause analyses when issues resulting in increased denials or decreased accuracy/productivity are uncovered.
• Develops and conducts targeted training to address root cause issues.
• Coordinates efforts with other departments as needed.
• Monitors department work queues to identify trends and opportunities for improvement.
• Maintains the department policy and procedure manual.
• Maintains a detailed record of improvement plans and achievements.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level
• Education Level: High school or GED