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   Current UPMC employees must apply in HR Direct

Sr Business Analyst, Patient Accounts - Harrisburg

  • Job ID: 196680244
  • Status: Full-Time
  • Regular/Temporary: Regular
  • Hours: 8:00 a.m. to 4:30 p.m.
  • Shift: Day Job
  • Facility: UPMC Pinnacle Hospitals
  • Department: Surgical Srvs-Bus Office
  • Location: 2601 North Third Street, Harrisburg PA 17110
  • Union Position: No
  • Salary Range: $27.17 to $42.45 / hour

Description

Purpose:
Support surgical services leadership across all 7 hospital locations with operational & financial data. This person needs to be flexible with work hours and be able to communicate effectively in front of a large group. This position performs a pivotal role in the billing process working with hospital registration and clinical departments to coordinate processes related to the billing and payment of claims. Working with little supervision this position leads as the top system expert within the Patient Accounts Department and has extensive revenue experience. The senior business analyst serves as project leader for department wide projects related to the system, coordinates system testing and implementation of system changes and testing of the Payer rules. The key goals are to develop streamlined revenue cycle processes to increase cash collections and maintain compliance with payer rules and regulations as they relate to claims generation.

Responsibilities:

  • Functions as a principle liaison, managing system and claims issue resolution in conjunction with the Patient Accounts, Coding, Contracting, Compliance, Patient Access, Information Services, and Hospital Clinical Departments. 
  • Coordinates meetings with Management staff within Patient Accounts and other departments to review, test and implement any changes due to the monthly payer rules, ECV Service Packs, enhancements, system upgrade, new initiatives and new facilities.
  • Coordinates testing of all system changes before moving them into production.
  • Identifies and/or develops key reports and utilizes Soarian reports and cubes to identify areas of concern in relation to system and claims problems.
  • Identifies the root cause of system issues and errors related to claim edits and documents the specific steps taken to reach error resolution, communicates error resolution steps to all required areas. 
  • Collaborates with Information Services to develop billing and claim rules that can be embedded within Soarian Financials to eliminate EBEW errors and claims issues.
  • Collaborates with the analyst over the Service Catalog to update the Soarian Financials Service Catalog to remediate errors of coding on claims. 
  • Works with Contract Manager Analyst to resolve issues with calculations of expected reimbursement.
  • Manages the edits and updates in the Claims System.
  • Works to minimize the number of edits, deletes invalid edits, and ensures successful claims submission to the clearinghouse.
  • Recommends, implements, and participates in process improvement projects related to claim production and claim error resolution.
  • Create and analyze reports to streamline manual intervention of claims and the claim flow and to identify system issues.
  • Prepare documents and give training to Patient Account's staff and other departments as needed and train new hires on the system.
  • Work as system expert to problem solve and improve department issues.
  • Provides feedback to directors and managers with regard to system issues and develops solutions.
  • Provides technical support to the Patient Account's staff and managers via phone, email, etc.
  • Serves as first level support for Soarian Financials system issues for Patient Accounts Dept.
  • Acts as a liaison between Patient Accounts and Information Services.
  • Participates on interdepartmental teams to understand the impact of process change on the system as a whole and enhance the functionality of Soarian Financials and support new initiatives. 
  • Supervises the Testing Analyst position, sets goals, gives direction to this person, monitors their work, and completes their evaluation.
  • Recommends changes/updates to the EBEW Administrative Policy and Procedure.
  • Provides timely information regarding recurring billing errors to the Revenue Cycle Director, and offers recommendations to identify revenue enhancement opportunities.
  • Actively participates in projects to support organizational goals Other duties as assigned.
  • Human Relations / Contact and Communications:The Senior Business Analyst has contact with Managers and Directors within the Pinnacle Health System. He/she has significant contact with other personnel throughout the System in resolution of issues related to the production of claims.
  • On a departmental basis, the Manager has significant interaction with subordinates. This position requires the ability to work with a large diverse staff. The interaction, which takes place, must be effective with both the exempt and non-exempt.

 

Qualifications

  • Bachelor's degree or 3 to 5 years Revenue cycle experience required. 
  • Extensive knowledge of Healthcare financial systems applications.
  • Experience with the latest generation of revenue cycle systems and strong knowledge of healthcare technology for hospitals/physician groups.
  • Extensive knowledge and understanding of Revenue Cycle business processes. 
  • Ability to develop, maintain and grow extensive, in-depth knowledge of billing error resolution approaches through education, self-study and research.
  • Ability to work collaboratively with all levels of the organization; and ability to negotiate and manage conflicts and issues.
  • Ability to work independently with minimal supervision. Strong interpersonal, verbal and written communication skills. Strong organizational and time management skills.
  • Solid analytical and problem-solving skills. 
  • Strong facilitation skills,Preferred Knowledge, Skills and Abilities: Siemens Soarian Financials system Project management experience. 
  • Extensive knowledge of third party billing requirements, ability to understand and facility (837I) 5010 Institutional Guide (IG) requirements. Reporting Technologies Microsoft Office Business Intelligence tools.
  • Licensure, Certifications, and Clearances:
    Clearances must be dated within 90 days
  • Act 33 with renewal
  • Act 34 with renewal
  • Act 73 FBI Clearance with renewal

  • UPMC is an Equal Opportunity Employer/Disability/Veteran

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   Current UPMC employees must apply in HR Direct