Reimbursement Analyst (FGP) - Manhattan - Operations

NYU Langone Health • New York, NY

2d • $66,300 - $94,382 • Onsite

About The Position

We have an exciting opportunity to join our team as a Reimbursement Analyst. In this role, the successful candidate will be responsible for reviewing physician utilization and payment data related to managed care reimbursement. This role is responsible for creating and analyzing contract compliance reports to measure and identify revenue opportunities from commercial payers to complement the Faculty Group Practice revenue cycle operations. The incumbent will work independently with minimal supervision analyzing payer reimbursement to identify trends and payments inconsistent with contractual rates and terms. The analyst will also present and communicate their findings to Management for internal and external escalation. The candidate for this role will work collaboratively with Revenue Cycle and FGP Operations to share the findings of their analysis and contribute as needed to assist in the development of tools and educational materials for FGP front end staff. The position requires a fundamental understanding of professional billing, industry standard reimbursement methodologies as well as the ability to interpret and understand managed care contracts.

Requirements

• Bachelor's degree in business or healthcare administration or related field plus a minimum of two years of experience; or an equivalent combination of education or relevant work experience.
• High level of analytical skills and dynamic communication skills (verbal and written) are required.
• Microsoft Excel and Word familiarity required.
• Qualified candidates must be able to effectively communicate with all levels of the organization.

Nice To Haves

• Previous experience in a healthcare finance or billing role.
• Skilled in data extraction, manipulation and analysis is preferred.

Responsibilities

• Evaluate and escalate eligibility, authorization, billing, and claims processing inaccuracies to the appropriate CBO and FGP Operations Management in order to implement upstream resolution and re-education.
• Function with minimal supervision, request feedback appropriately, and initiate inquiries to gain additional understanding.
• Perform audits to identify and recover underpayments caused by contract misinterpretation and invalid denials in order to maximize reimbursement, efficiently lower A/R, and expedite the revenue cycle process.
• Collect and analyze data to determine denial and underpayment trends across the Faculty Group Practice for review and distribution to leadership.
• Execute data mining and in-depth analysis to support managed care contracting initiatives.
• Assist with providing constructive feedback and developing training tools.
• Work collaboratively with a variety of departments within NYU School of Medicine and externally with commercial managed care payers.
• Learn appropriate new software systems to help analyze and evaluate claims data.
• Work independently, take initiative, and think critically.
• Maintain data integrity when manipulating data files for purposes of analysis to ensure data does not become corrupted through conscientious use of tools and a system of checks and balances.
• Develop a comprehensive understanding of all managed care contractual terms and reimbursement methodologies between NYU School of Medicine and external commercial payers.
• Serves as NYU Langone Health Faculty Group Practice Brand Ambassador by upholding the NYULH Mission, vision and values and promoting excellence in the patient experience, during every encounter.
• Drives consistency in every patient and colleague encounter by embodying the core principles of our FGP Service Strategy CARES (Connect, Align, Respond, Ensure, and Sign-Off).
• Greets patients warmly and professionally, stating name and role, and clearly communicates each step of the care/interaction as appropriate.
• Works collaboratively with colleagues and site management to ensure a positive experience and timely resolution for all patient interactions and inquiries whether in person, by phone or via electronic messaging.
• Proactively anticipates patient needs, and participates in service recovery by applying the LEARN model (Listen, Empathize, Apologize, Resolve, Notify), and escalates to leadership as appropriate.
• Shares ideas or any observed areas of opportunity, to improve patient experience and patient access, with appropriate leadership. (i.e. ways to optimize provider schedules, how to minimize delays, increase employee engagement, etc.)
• Partners with Patient Access Center and Central Billing Office team members to support collaboration and promote a positive patient experience.
• Takes a proactive approach in ensuring that practice staff are fully versed in the Access Agreement gold standard principles.

Benefits

• Financial security benefits
• Generous time-off program
• Employee resource groups for peer support
• Holistic employee wellness program (physical, mental, nutritional, sleep, social, financial, and preventive care)

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level