HOSPITAL BILLING REVENUE CYCLE ANALYST
Req #: | 167418 |
Department: | |
Job Location: | Other Location |
Posting Date: | 05/08/2019 |
Closing Info: | Open Until Filled |
Salary: | Commensurate with education and experience |
Shift: | First Shift |
Notes: | This position provides opportunities to work in a fast-paced, challenging, diverse and rewarding environment. As an employee you will enjoy generous benefits and work/life programs. For detailed information on Benefits for this position, click here. |
The UW Medicine Revenue Cycle Analyst is both an operational subject matter expert and Epic systems expert who proactively identifies process and system opportunities and assists Revenue Cycle leadership in the coordination of complex projects that promote operational efficiencies and enhance system tools. The UW Medicine Revenue Cycle Analyst works independently, coordinating and performing identified actions among and between all levels of Revenue Cycle (hospital and physician), PFS, Clinical and Financial department staff to resolve complex issues on accounts and patient records. Ensure all revenue is captured appropriately and billed in a timely and compliant manner.
The UW Medicine Revenue Cycle Analyst assists with coordinating the plan, design, documentation testing and implementation of process and system application enhancements. The position incumbent must have skills and knowledge that span the entire revenue lifecycle, this includes but is not limited to expertise in billing applications from initial business process analysis and requirements gathering, through Epic system stabilization, error resolution, denial reduction, to process analysis and improvement. This role is responsible for working with a diverse group of people from all UW Medicine entities to analyze, identify new features for new version upgrades to Epic and research and recommend new process solutions for the functions in Hospital / Professional Billing and Coding. This requires a deep understanding of all charge capture, coding and hospital billing operations, cross-functional systems knowledge and support skills for applications used in conjunction with Epic functions by multiple UW Medicine customer groups. This analyst must also have an understanding of the uses, rules and build of the work queues and their corresponding edits.
The Enterprise Revenue Cycle Operations group consists of individuals at UWMC, HMC, and NWH, and supports operational groups involved in Epic charging and billing (Clinics / Departments, Patient Access, Hospital / Professional Billing, Finance and other related operations that use Epic functionality). This group is responsible for ongoing support and maintenance of the infrastructure and Epic application which support these institutions, along with the implementation of new services and applications that are used to support and further the mission of patient care, research and teaching.
The UW Medicine Revenue Cycle Analyst is responsible for working on issue resolution and data quality projects requiring a broad knowledge of all aspects of Epic and related systems. This individual performs analysis of system issues, fixes immediate issues, redesigns workflows and performs testing, and works with operational personnel to match system technical capabilities with the business requirements of UW Medicine.
The primary responsibilities of the HB Revenue Cycle Analyst are to:
• Analyze hospital / professional revenue cycle processes and procedures with a focus on optimizing the use of Epic functionality to ensure the highest level of revenue is recognized through compliant practices and guidelines.
• Participate in determining the priority, usage and implementation plan for new features and functionality during new version upgrades.
• Proactively review and evaluate system updates and participate in the upgrade implementation; including analysis, design, testing, communication and implementation of these updates.
• Partner with HIM / Coding, Peer Systems, Charge Capture and Clinics / Departments to ensure timely billing resulting in clean claims and reduced late charges and denials.
• Define and document customer requirements.
• Proactively monitor and maintain systems.
• Perform problem resolution.
• Develop and maintain QA documentation.
• Identify error patterns and recommend training or revised workflows.
• Provide regular status reporting.
• Other duties, as assigned.
Characteristic Duties & Responsibilities
ENSURE INPUT DATA ARE HIGHEST QUALITY NECESSARY TO PRODUCE CLAIM CLAIMS AND REDUCE DENIALS
Proactively monitor and resolve Epic Account, Charge Review, Charge Router, and Claim Edit WQs for charge processing and compliance.
Assist in resolution of application and process problems
Answer calls and provide information on application use and process issues.
Work closely with the UW Medicine IT Services Help Desk to provide efficient and responsive support to end users.
Provide supportive and positive mechanisms for reporting application and systems deficiencies, and facilitate reporting of suggestion for system improvements.
ANALYZE BUSINESS PROCESSES AND PROCEDURES
• Research and analyze current and proposed hospital and physician business practices and system upgrades and impact along the entire revenue cycle.
• Utilize data to develop reports that will be used by clinical departments, clinics and Revenue Cycle functional areas to identify issues and monitor issue resolution.
• Recommend new process improvements that ensure clean claims, are compliant with payer requirements and governmental regulations, and reduce denials.
• Evaluate possible vendor solutions and system products that enhance the quality, track data compliance with patient access and claims-related functionality.
• Observe and interview employees regarding operations and procedures.
• Act as an expert resource to UW Medicine staff by anticipating and identifying educational, procedural and functional problems associated with the revenue cycle system applications and cross-system interfaces.
• Set appropriate expectations of customer requirement fulfillment.
• Define screens, reports and processes (manual as well as automated).
• Provide functional expertise to optimize the design and development of revenue cycle systems.
• Act as liaison between UW Medicine IT Analysts and end users requiring assistance with complex issues.
• Analyze reported system issues to determine if operational, training or build issue within the Epic applications.
• Be champion for end user issues, and assist in prioritization and possible system / process resolution.
• Using quality improvement principles, monitor system impact on user and departmental workflows and incorporate results into system enhancements.
DEFINE AND DOCUMENT CUSTOMER REQUIREMENTS
• Act as quality assurance liaison between application system end users, revenue cycle leadership, training resources and system developers.
• Act as a liaison and/or facilitate communication between end users and IT Services system administrators, other analysts and programmers.
• Participate in leading workgroups to provide diagnostic assistance, resolution to questions, and problem direction.
• Maintain clear and consistent communication with all levels of user groups regarding changes to systems.
PROACTIVELY REVIEW, EVALUATE, MONITOR AND MAINTAIN SYSTEM FUNCTIONALITY
• Work with all required (intradepartmental & interdepartmental) personnel to define and manage changes to system and/or functional workflows.
• Perform problem resolution.
• Perform analysis and troubleshooting for application issues.
• Provide regular status to management, customers, and stakeholders.
Maintain issue tracking tools to manage operational issues to feed regular status reports.
DEVELOP AND MAINTAIN QA DOCUMENTATION
• Identify and report patterns of QA system and revenue cycle business requirements non-compliance.
• Summarize denial patterns and issues created by front end registration and admission errors
• Document proposed data flows.
• Assist with and document the development of new standard operational procedures.
• Provide weekly status reports on progress to revenue cycle leadership. Information should be accurate timely, and pertinent.
OTHER DUTIES, AS ASSIGNED
• Act as backup for other team members and functions, as needed
• Complete ad-hoc system and/or process analysis / documentation as assigned
Supervision Received
Works independently and in team environments
Participates in leadership of design and implementation groups
Provides status reports to leadership as required
Supervision Exercised
Coordinate team effort to create the plan, and the design and implementation of Epic ADT new version/system upgrades
Manage medium to large, complex projects, as assigned. Lead process improvement efforts, as assigned.
• Fast-paced professional office environment
• Normal working hours. May also work off hours and weekends.
Manage small to medium projects, as assigned. Lead process improvement efforts, as assigned.
Bachelor's degree (BA / BS) in Business, Healthcare Administration, IT, analytical sciences or equivalent applicable experience in Hospital Information Systems, Patient Financial Services (billing / claim follow-up), HIM / Coding and / or Hospital Clinic or Department Operations (charging / charge capture expertise).
REQUIREMENTS:
At least 5 years total to include 3 years of concurrent experience in Hospital Information Systems / IT, Patient Financial Services, HIM / Coding or Clinical Department positions as a lead or other similar position where analysis and problem solving skills have been demonstrated. Minimum 5 years of experience performing progressively more complex and responsible tasks. Working knowledge of charge functions in hospital billing and department systems, and data / reporting related to HIM / Coding and Patient Access / ADT processes.
Demonstrated excellence in both internal and external customer interaction and written and verbal communication skills. Strong customer focus and management of customer expectations; ability to establish and maintain a high level of user trust and confidence in the a variety of groups.
DESIRED:
Certified Professional Coder (CPC) certification and / or Healthcare Financial Management Association (HFMA) sponsored certification [Certified Healthcare Fianncial Professional (CHFP) / Certified Revenue Cycle Representative (CRCR)], is desired.
Expertise creating reports using database and data visualization tools is also a plus.
CONDITIONS OF EMPLOYMENT:
Must be willing to travel to Madison, Wisconsin for EPIC training and be certified within 90 days of training completion.
• Fast-paced professional office environment
• Normal working hours. May also work off hours and weekends.
• Must have personal transportation for quick access to multiple sites, including both medical centers and UW Medicine Services
Committed to attracting and retaining a diverse staff, your experiences, perspectives and unique identities will be honored at the University of Washington. Together, our community strives to create and maintain working and learning environments that are inclusive, equitable, and welcoming.
The University of Washington is a leader in environmental stewardship & sustainability, and committed to becoming climate neutral.
The University of Washington is an equal opportunity, affirmative action employer. To request disability accommodation in the application process, contact the Disability Services Office at 206-543-6450 / 206-543-6452 (tty) or dso@uw.edu.