Financial Analyst -- Revenue Integrity -- General Hospital

CAMC Health System•Charleston, WV

About The Position

The Financial Analyst collects and prepares financial data and analyzes fiscal accounting and related systems to report on the financial activities and position of the MSO’s clients. The role reviews claims and payment data to support accurate billing to and payments from commercial, managed care, and government payers, and to ensure compliance with payer contracts and fee schedules. It researches and documents trends, with a focus on identifying charging and documentation opportunities. The analyst prepares and evaluates financial feasibility and administrative planning studies; maintains data for financial reporting, budgets, and forecasts; analyzes physician practice operations; and develops recommendations and documentation for fiscal services, accounting systems, policies, and procedures. The position works closely with payer contracting and other teams to monitor contract rates, claims, payments, reimbursements, denials, and charge capture, and to resolve discrepancies and follow-up items. It also supports client education, maintains detailed financial records, reviews client and vendor contracts, assists with special projects, attends meetings and committees, and pursues ongoing professional development. The employee must meet the department’s competency-validation requirements, maintain required education, provide positive customer and coworker service, comply with attendance and organizational policies, and perform work in a cost-effective manner in alignment with the organization’s mission and quality-improvement activities. The role may involve work under departmental scheduling and pay practices, including overtime, varied shifts, or on-call situations.

Requirements

Bachelor’s degree in Accounting, Business, Finance, or a related field.
At least 2 years of related financial/accounting experience; the posting also specifies 3+ years of related experience.
A bachelor’s degree and 2 years of financial/accounting experience may be substituted by 10 years of related experience in a patient accounting position and 2 years of experience in an analytical role.
Demonstrate competency through initial orientation and ongoing competency validation to perform the tasks and duties specified in the job description and department competency checklist.
Maintain and document applicable required education.
Driver’s license; the posting states that all licensure must be current and valid and from West Virginia.

Nice To Haves

Grant or sponsored project experience preferred.

Responsibilities

Prepare financial feasibility studies and review or evaluate studies and administrative planning studies as assigned.
Prepare, analyze, and maintain financial data for financial reporting, budgets, and forecasting.
Analyze the financial operations of physician practices and prepare recommendations and documentation for fiscal services and related policies and procedures concerning accounting systems.
Conduct or assist with presentations of fiscal educational sessions to prospective clients.
Accumulate and maintain detailed records of clients’ assets, liabilities, revenues, and expenses.
Periodically review client contracts, including vendor and payer contracts.
Assist the Director and/or Finance Manager with special projects as assigned.
Attend meetings and participate on committees as requested.
Maintain professional growth and development through in-service meetings, educational programs, seminars, conferences, and workshops.
Work with the Payer Contracting Department to ensure accurate rates and payment terms are loaded into company-approved contract management systems used to monitor billing and payment activity.
Ensure claims and payment data are loaded into company-approved monitoring systems and resolve discrepancies in a timely manner.
Monitor contracted payer payments for timeliness and compliance with contracted payment terms.
Review reimbursement and variance reports to identify trends and discrepancies.
Prepare detailed non-payment and underpayment reports and distribute them to appropriate teams for resolution and follow-up.
Review denial reports to identify trends and recommend solutions.
Use company-approved charge-capture auditing systems to identify missed charges and work with relevant departments to resolve issues.
Maintain and document required education; provide positive customer service and coworker relations; comply with attendance, scheduling, pay-practice, and departmental policies; participate in quality-improvement activities; and perform work cost-effectively and in alignment with the organization’s mission.
Perform other related duties as assigned.