Reimbursement HC Analyst 3-HB Patient Financial Services-FT-Day

University of California System•Anaheim, CA

30d

About The Position

UCI Health is the clinical enterprise of the University of California, Irvine, and the only academic health system based in Orange County. UCI Health is comprised of its main campus, UCI Medical Center, a 459-bed, acute care hospital in in Orange, Calif., four hospitals and affiliated physicians of the UCI Health Community Network in Orange and Los Angeles counties and ambulatory care centers across the region. Listed among America's Best Hospitals by U.S. News & World Report for 23 consecutive years, UCI Medical Center provides tertiary and quaternary care and is home to Orange County's only National Cancer Institute-designated comprehensive cancer center, high-risk perinatal/neonatal program and American College of Surgeons-verified Level I adult and Level II pediatric trauma center, gold level 1 geriatric emergency department and regional burn center. UCI Health serves a region of nearly 4 million people in Orange County, western Riverside County and southeast Los Angeles County. To learn more about UCI Health, visit www.ucihealth.org. Position Summary: Serves as liaison between Patient Financial Services UC Irvine Health and legal business partners in the investigation, management, resolution and defense of claims, appeals, arbitrations or any other form of disputes up to and including legal proceedings. The duties vary including support of matters in pre-litigation and active litigation. Other legal work involves management of subpoenas, court appearances, mediations and trial appearances. This incumbent exhibits advanced knowledge of contract terms and conditions, serves as denial specialist and acts as a resource to other staff dealing with difficult accounts requiring troubleshooting assistance. Responsible for identifying trends by the payers and UCI, assisting in the resolution as appropriate.

Requirements

Skilled at using computerized systems and applications to maintain/update patient accounting information
Must possess the skill, knowledge and ability essential to the successful performance of assigned duties
Must demonstrate customer service skills appropriate to the job
Minimum 5 years' experience acute hospital billing and collections, contract interpretation and claim denial resolution
Good math skills to perform a variety of calculations related to patient accounting
Excellent written and verbal communication skills in English
Excellent communication skills to effectively interact with PFS staff, leaders of the organization, payers, patients and their families and the external community
Effective data and numerical data entry skills
Demonstrated experience in CPT, HCPC and ICD billing codes, authorization requirements and related documentation
Advanced knowledge of revenue cycle processes gained from previous related work experience in a healthcare setting
Advanced knowledge of a variety of non-governmental and governmental payers
Ability to think critically and problem solve independently and/or collaboratively as the situation dictates
Ability to resolve routine and non-routine errors independently and to assist others in problem solving
Ability to maintain a work pace appropriate to the workload
Ability to establish and maintain effective working relationships across the Health System

Nice To Haves

Prior reimbursement analyst experience
Legal or paralegal training(CPHRM)
Knowledge of University and Medical Center organizations, policies, procedures and forms
Bachelor's Degree in Business, Finance, or related field, or an equivalent combination of education and experience

Responsibilities

Serves as liaison between Patient Financial Services UC Irvine Health and legal business partners in the investigation, management, resolution and defense of claims, appeals, arbitrations or any other form of disputes up to and including legal proceedings.
The duties vary including support of matters in pre-litigation and active litigation.
Other legal work involves management of subpoenas, court appearances, mediations and trial appearances.
This incumbent exhibits advanced knowledge of contract terms and conditions, serves as denial specialist and acts as a resource to other staff dealing with difficult accounts requiring troubleshooting assistance.
Responsible for identifying trends by the payers and UCI, assisting in the resolution as appropriate.