Billing Financial Analyst, Cbo

Jackson Memorial Hospital
Corporate Business Office Dept.
Days, Full Time
Position Summary:
CBO Billing Financial Analyst performs various interviewing, fact collection and financial evaluation tasks in connection with credit and collection in a large and diversified hospital serving both non-indigent and indigent patients qualifying for various types of specialized assistance programs. Incumbents may specialize in either credit or collection work or a combination of both. Primary emphasis is on financial counseling with patient from pre-admission through account becoming a discharged zero balance. Incumbents are responsible for interview of patient, family or guarantor to explain charges, hospital policy and payment procedures.
Duties & Responsibilities:
Identify and resolve accounts through the use of existing Patient Accounting Systems. Runs billing edit reports of claim processing, holds, errors as requested. Receives and processes requests from third parties for additional information (i.e.: medical records, charge explanations and accident details). Maintains files for future reference. Updates JHS Patient Accounting System with any changes to financial class, insurance eligibility, etc. based on new or updated information. Reviews claims for accuracy, performs required edits, and submits claims and rebills to payors daily in paper and/or electronic format to ensure accurate and timely filing of claims and prompt payment. Investigates and corrects the billing edits for physician license number and billing documentation, in order to expedite payment process. Works claims on hold and/or notifies Medical Records of approaching filing deadlines to ensure all efforts are made to file the claim before the filing deadline. Research and document all billing activity and post comments into the JHS Patient Accounting System. Coordinates medical record request as needed. Accurately document work activity on-line for future departmental reference. All documentation should be clear, concise and easily understood by others. Basic understanding of medical terminology/HCPC coding and how it relates to patient medical service. Understanding of National billing codes (UB04) and the Payor requirements for these codes . Works with supervision, management and the patient accounting staff to improve processes, increase accuracy, create efficiencies and achieve the overall goals of the department. Maintains productivity and quality standards in accordance with department policy and procedure. Informs the Supervisor of any problems or changes in Payor requirements. Exercises independent judgment to analyze and report repetitive edit failures so corrective actions can be taken. Maintains knowledge of applicable rules, regulations, policies, laws, and guidelines that impact billing. Attends scheduled department meetings and training sessions. Must be very detail-oriented and accustomed to high volume output. Demonstrates behaviors of service excellence and CARE values (Compassion, Accountability, Respect and Expertise). Performs other job duties that may be required to provide the quality and level of service expected by JHS and Revenue Cycle management.
Experience:
Generally requires 3 to 5 years of related experience.
Education:
High school diploma is required. Bachelor's degree in related field is strongly preferred.
License Certification:
Valid license or certification is required as needed, based on the job or specialty.
Knowledge Skill Abilities:
Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines. Ability to communicate effectively in both oral and written form. Ability to handle difficult and stressful situations with critical thinking and professional composure. Ability to understand and follow instructions. Knowledge and skill in use of job appropriate technology and software applications.
Physical Demands:
Job function is sedentary in nature and requires sitting for extended periods of time. Function may require frequent standing or walking. Must be able to lift or carry objects weighing up to 20 pounds. Jobs in this group are required to have close visual acuity to perform activities such as: extended use of computers, preparing and analyzing data and analytics, and other components of a typical office environment. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).
Work Environment:
Jobs in this group are required to function in a fast paced environment with occasional high pressure or emergent and stressful situations. Frequent interaction with a diverse population including team members, providers, patients, insurance companies and other members of the public. Function is subject to inside environmental conditions, with occasional outdoor exposures. Possible exposure to various environments such as: communicable diseases, toxic substances, medicinal preparations and other conditions common to a hospital and medical office environment. May wear Personal Protective Equipment (PPE) such as gloves or a mask when exposed to hospital environment outside of office. Reasonable accommodations can be made to enable people with disabilities to perform the described essential functions. Additional information and provision requests for reasonable accommodation will be provided by the home unit/department in collaboration with the Reasonable Accommodations Committee (RAC).