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Form of work
Salary- Job Type: Officer of Administration
- Bargaining Unit:
- Regular/Temporary: Regular
- End Date if Temporary:
- Hours Per Week: 35
- Standard Work Schedule: 9-5 M-F
- Building: 400 Kelby St, Fort Lee, NJ 07024
- Salary Range: 70,000-77,500
- Job Type: Officer of Administration
- Bargaining Unit:
- Regular/Temporary: Regular
- End Date if Temporary:
- Hours Per Week: 35
- Standard Work Schedule: 9-5 M-F
- Building:
- Salary Range: 70,000-77,500
Position Summary
The Revenue Cycle Junior Analyst (Reimbursement) is responsible for identifying reimbursement discrepancies inclusive of both under and over payments, resolving root cause and submitting appeals to insurance carriers for correct payment. The analyst will provide analytic support, problem solving and communication with Healthcare payers, clinical departments, contracting office and other management.
Responsibilities
Operations
- Reviews paid claims and ensures reimbursement integrity in accordance with contracted reimbursement.
- Reviews and analyzes “Explanation of Benefits” (EOBs) to identify under-allowed claims.
- Utilize contract management tools such as Experian to identify payment variances between contracted rates and actual insurance payments.
- Submit self-disclosure files along with refund checks to insurance carriers for overpayments based on contracted rates.
- Submit bulk appeals to dispute under-payments based on contracted rates.
- Compiles and batches appeals by payer, issue, or other pertinent criteria for expedited re-processing of claims.
- Monitors and tracks contractual, billing, registration, and posting errors, and provides continuous feedback to management team.
- Prepares monthly performance statistics regarding appeals, recoveries, and refunds. Perform analysis and identify corrective action plans to address root issues.
- Performs routine follow up such as monitor recoveries to track payment on appeals, communicate with payer liaisons, and escalate as required.
- Validates claims files to ensure that all data elements and claim submissions are accurate and compliant.
- Provides feedback to unit Manager to provide claims recovery status and open issues.
- Participates in meetings to discuss ongoing trends and issues regarding the administration of managed care contracts.
- Participates in professional development efforts to be current in managed care reimbursement trends.
- Keeps apprised of rules and regulations affecting reimbursement. Stays current through appropriate journals and personal contacts of such developments in the industry as may increase the effectiveness of operations.
- Assist on other Revenue Cycle projects.
Strategic
- Work collaboratively with clinical departments to establish effective communications to further the efficiency of the Revenue Cycle process.
- Develops and maintains a good productive and collaborative relationship with departmental management and representatives.
Compliance and Other
- Performs other Revenue Cycle tasks as assigned by management as a member of a large central business office.
- Represents the FPO on committees, task forces and work groups as assigned.
- Conforms to all applicable HIPAA, Billing Compliance and safety policies and guidelines.
Minimum Qualifications
- Requires bachelor’s degree or equivalent in education and experience.
- Minimum of 3 years’ related experience.
- An equivalent combination of education and/or experience may be considered.
- Demonstrated proficiency in health insurance billing, collections, and eligibility as it pertains to commercial and managed care, and self-pay reimbursement concepts.
- Demonstrated strong skills in problem assessment, resolution and collaborative problem solving in complex, interdisciplinary settings.
- Must demonstrate strong skills managing high volume of data, data sets, and related materials.
- Excellent analytical skills: attention to detail, critical thinking ability, decision making, and researching skills in order to analyze a question or problem and reach a solution.
- Demonstrated proficiency in contract management applications.
- Ability to work collaboratively with a culturally diverse staff and patient/family population, strong customer service skills, demonstrating tact and sensitivity in stressful situations.
- Ability to work independently and follow-through and handle multiple tasks simultaneously.
- Excellent verbal and written communication skills.
- Intermediate level proficiency of Microsoft Office (Word & Excel) or similar software is required and an ability and willingness to learn new systems and programs.
- Must be a motivated individual with a positive and exceptional work ethic.
- Must successfully complete systems training requirements.
Preferred Qualifications
- Knowledge of Experian contract management software is preferred.
Competency Profile
Patient Facing Competencies
Minimum Proficiency Level
Accountability & Self-Management
Level 3 - Intermediate
Adaptability to Change & Learning Agility
Level 3 - Intermediate
Communication
Level 3 - Intermediate
Customer Service & Patient-Centered
Level 3 - Intermediate
Emotional Intelligence
Level 3 - Intermediate
Problem Solving & Decision Making
Level 3 - Intermediate
Productivity & Time Management
Level 3 - Intermediate
Teamwork & Collaboration
Level 3 - Intermediate
Quality, Patient & Workplace Safety
Level 3 - Intermediate
Leadership Competencies
Minimum Proficiency Level
Business Acumen & Vision Driver
Level 1 - Introductory
Innovation & Organizational Development
Level 1 - Introductory
Equal Opportunity Employer / Disability / Veteran
Columbia University is committed to the hiring of qualified local residents.
