Lead Financial Analyst

Founded in 2014, Crossroads capabilities are Program Management, Recruiting & Staffing, Administrative, Human Resources, and Paralegal Support. Crossroads is built upon the foundation of our four basic principles Honor, Integrity, Dedication, and Respect. Our core competency is serving our customers by providing professional and administrative services support to help them successfully accomplish their mission.

**Contingent Upon Award**

Job Description:

Background:

Crossroads Talent Solutions is seeking a motivated and qualified individual to serve as the Lead Financial Analyst to support the Defense Health Agency at Walter Reed National Military Medical Center.

Responsibilities Include:

-Responsible for determining the highest possible benefit payable to the Military Treatment Facility
-Lead Financial Analyst will lead other members of Uniform Business Office as they perform their mission of accurately collecting third party payments
-Develop additional documents as required to ensure the maximum amount recoverable under the policy.
-Write justifications or special determinations related to payments received, i.e. explain why full amount billed was not paid, why the amount paid is to be written off, why money must be returned to the insurance company, etc.
-Responsible for classifying accounting transactions in automated systems, symbolic codes are used extensively.
-Provides input to the UBO Manager for analytical and evaluative methods to improve the processes of the TPCP.
-Refer serious complaints lacking resolution to higher level supervision.
-Explains and answer questions regarding the inpatient and outpatient Third Party Collection Program to patients and their insurance companies, to include entitlements, billing procedures and benefits.
-Assigns and explains work to subordinate employees.
-Coordinates to meet deadlines, providing a continuous smooth flow of work through the office and expedites process of priority cases.
-Reviews work for completeness, accuracy and compliance with regulatory requirements.
-Audits work daily performed appropriate International Classification of Diseases (ICD10) and Current Procedural Terminology (CPT-4) codes, clinical rate; payments posted to accounts and denied or reduced payment compliance guidelines.
-Submit inpatient and outpatient claims, reviewing inpatient and outpatient claims, making followup calls as necessary.
-Post accounting transaction for payments received from the Insurance Companies to appropriate computerized ledgers and subsidiary records. Verify amounts received against amounts billed.
-Closed the amount when less than the received amount is deemed correct, or re-bill the third party payer for the difference.
-Contact the insurance company or its designated reviewing organization to obtain precertification approval prior to admission or same day surgical procedure.
-Collect, organize and prioritize data, files and claims in a timely manner. File claims appropriately stamping correct codes on inpatient and outpatient claims.
-Prepare denial request letters based on inability to provide itemized bill statements.
-Run reports weekly from ABACUS to identify errors and call vendors to correct such errors.
-Train new employees on the billing system Armed Forces Billing and Collection Utilization Solution (ABACUS)
-Print UB-04 and CMS 1500 forms three times a week and distributes to the appropriate Billers.
-Answer telephone inquiries from within WRNMMC regarding patient status, admissions dispositions, length of convalescence and transfer status.
-Retrieves medical records and other data for research projects and for diagnostics, training or review purposes.
-Coordinate the performance and daily distribution of identification and collection of Other Health Insurance (OHI) patient information for all billable clinics that support the Uniform Business Office (UBO) revenue generation for WRNMMC.
-Provide recommendations on Third Party Collection Program (TPC), Uniform Business Office (UBO) compliance that follow medical documentation and billing rules and standards.
-May communicate with Administrative coordinators throughout the hospital on Outpatient Itemized Billing (OIB) procedures to ensure that optimal reimbursement is attained for their respective.
-Train clinics personnel on the proper procedure use of the DD-2569 forms.
-Educating and training others (patients' clinical staff members, managers) on the importance of the OHI (Other Health Insurance) Program regarding the Patient's DD2569 Form.
-Train others in utilizing the installed clinic scanners (which scans the patients' insurance card).
-Aggressively follow-up with third party payers on billed claims that are more than 30, 60, 90 and 120 days or more to ensure payment is received from insurance carriers on claims in a timely manner.
-Reconciling accounts accurately in a timely manner in ABACUS/General Ledger according to the UBO Guidelines and the patients' specific health benefits policy.
-Cross trains other staff members in the different functions related to the Financial Technician Position.

Qualifications:

-Must have a minimum of 2-3 year experience with standard office financial and administrative functions with excellent verbal and writing skills. Must have a High School Diploma, or Associate Degree or higher.
-Basic knowledge of medical terminology.
-Knowledge of the hospital computer system (CHCS) and ABACUS (Gov. will train).
-Working knowledge of Microsoft Office.
-Ability to use general office equipment including telephone, fax, copier, etc.
-Customer service expertise.
-Ability to use automated systems effectively
-Post accounting transaction for payments received from the Insurance Companies to appropriate computerized ledgers and subsidiary records.
-Detailed intensive knowledge of policies, precedents, goals, objectives, regulations, and guidelines of a functional area.
-Ability to lead supervise and motivate employees.

Veterans encouraged to apply.

Crossroads Talent Solutions, LLC is a Veteran friendly employer and provides equal employment opportunity (EEO) to all employees and applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability status, genetic information, marital status, ancestry, protected veteran status, or any other characteristic protected by applicable federal, state, and local laws.

Equal Opportunity Employer/Veteran/Disabled