Patient Account Analyst - Special Programs - Vendors - 100% Remote

At Duke Health, we're driven by a commitment to compassionate care that changes the lives of patients, their loved ones, and the greater community. No matter where your talents lie, join us and discover how we can advance health together.

 

About Duke Health's Patient Revenue Management Organization

 

Pursue your passion for caring with the Patient Revenue Management Organization, which is Duke Health's fully integrated, centralized revenue cycle organization that supports the entire health system in streamlining the revenue cycle. This includes scheduling, registration, coding, billing, and other essential revenue functions.

 

 

 

REMOTE POSITION: Monday - Friday

 

 

General Description of the Job Class:

Extract, prepare and analyze complex data, accounts and/or financial reports.

Review, analyze, trend, present and advise leadership regarding conclusions and recommendations.

Facilitate/implement resolutions focused on denial reduction initiatives

Serve as subject matter expert resource for covered areas

 

Duties and Responsibilities of this Level:

Analysis/Trending/Support /Liaison (70%):

• Conduct detailed analysis and research to identify denial/payor trends, including a review of account specifics to support/validate finding s and/or provide recourse for denied accounts/avoidable adjustments.

 

• Provide detailed review and recommendations for reduction in AR aging, Avoidable write offs, denial AR and high dollar AR.

 

• Prepare/present written reports/presentations and analyses for leadership, highlighting trends and providing appropriate recommendations, solutions, and/or conclusions.

 

• Serve as a subject matter expert resource to leadership in the decision-making process surrounding denial prevention strategies. Plays an integral role in implementing and managing change related to this area of expertise.

 

• Serve as liaison to entity management and staff, documenting reports and analyses as well as discussing results, trends and recommendations with various stakeholders.

 

• Act as a technical resource to operational management and staff on the appropriate interpretation of denial/financial data.  Coordinate with and mentor staff regarding accounts receivable and financial systems, analyses, reports and policies/procedures.

 

• Continue review of weekly invoice analysis, to document, identify and implement opportunities for increased upstream logic to prevent, or education/logic correction to totally eliminate aging, denials or avoidable write offs.

 

• Continue weekly production of clear analysis facts and documentation; alert situations and descriptions related to aging patterns and avoidable concerns and invoice review results.  This includes meeting weekly and monthly reporting deadlines for AR summaries.

 

• Collaborate closely with other analysts in the department as well as additional departmental resources for further identification and documentation of opportunities to reduce aging AR and improve overall workflow processes.

 

• Focus on expansion of knowledge base around Excel, documentation analysis, formal PowerPoint presentation optimization, dashboard review, and Epic reporting mechanisms (SlicerDicer).

 

• Continue to enhance performance and clear communication of presentation of material to leadership in monthly meetings and in email request.  < /span>Specifically, AR summaries for monthly Department RIC and PDC department presentations.

 

• Evaluate opportunities to implement claim edits where applicable to reduce downstream, back-end denials and improve health system A/R turnaround time as a result.

 

• Maintain organization of ongoing trending and analysis via a report repository in Box/shared drive.

 

• Identify process improvement opportunities to include staff education/training, operational workflow modifications, system enhancements and external payer policy changes as well as working with and engaging appropriate personnel to implement and test change processes.

 

• Maintain and update Issue Logs related to identified denial analysis tr ends and work with Payer Relations to establish coordinated resolution s thereof.

 

• Organize and lead committee meetings across our entity as it relates to A/R and denial mgmt.

 

 

Technical Expertise (25%):

 

• Develop and maintain a working knowledge of all functions performed by the PB&C department

 

• Develop and maintain a