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Analyst Payment Variance

Cape Cod Healthcare


Location:
Hyannis, MA
Date:
01/22/2018
2018-01-222018-02-20
Categories:
  • Financial Services
  • Information Technology
  • Healthcare
Cape Cod Healthcare
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Job Details

Cape Cod Healthcare

Department: Revenue Cycle
Schedule: Temporary 40 Hours per week
Shift: Day Shift
Hours: 8a-4p Monday-Friday
Job Details:

Cape Cod Healthcare is the leading provider of healthcare services for residents and visitors of Cape Cod.  With more than 450 physicians, 4,700 employees, and 1,100 volunteers, Cape Cod Healthcare operates two-acute care hospitals, the Cape's leading provider of homecare and hospice services (VNA), a skilled nursing and rehabilitation facility (JML Care Center), an assisted living facility (Heritage at Falmouth), the Cape's only local laboratory service (CCHC Laboratory Services) and numerous health programs.  We are currently seeking a dedicated Payment Variance Analyst to join our team at Cape Cod Hospital.

 

PURPOSE OF POSITION:

Review, analyze, develop, recommend and implement Process Improvement changes for the department to improve efficiency and work flow.

 

PRIMARY DUTIES AND RESPONSIBILITIES:

1.     Troubleshoot and evaluate work product of staff, make recommendations to management and implement changes. 

2.     Participate with management in strategizing for Process Improvement initiatives.

3.     Attend and participate in management meetings.

4.     Work with management on special organizational projects for CCHC.

5.     Participate in and provide input and feedback for employee evaluations.    

6.     Works with managed care contracting, Patient financial services, software vendors, third party payer payers to identify root cause of payment variances and address and make appropriate changes to resolve payment variances.  

7.     Resolves payment variance issues and ensures that the hospital is reimbursed correctly according to the contract terms.

8.     Monitors and audit payment variance software to ensure contracts are properly loaded and payment calculations are correct.

9.     Review payment variance reports for accuracy.

10.  Analyze payment transactions and identify trends using Payment Variance Software, Websites and other online communications.  Identify missing charges and work with Clinical Departments, Physician Clinics and Practices to develop new charges.

11.  Collaborate with department managers and staff to review documentation supporting charge capture, identify areas of deficiency and develop process improvement programs to support compliant billing

12.  Assist the Senior Clinical Manager in developing ongoing educational programs on charge capture and reconciliation for department managers and their staff

13.  Develops and deliver organized, concise yet thorough communications to management, Sr. Leadership, and other departments regarding proposed, deficiencies, developments and opportunities affecting the Organization with regard to charge capture and payment variances.

14.  At the request of clinical department managers, attend staff meetings to present identified problems and solutions related to payment variance, reconciliation and documentation.

15.  Working with department managers, develop and revise tools for documenting departments' processes for charge capture and reconciliation to prevent payment variances.   Assure that all tools are reviewed and revised periodically.  Monitor CCHC intranet website to assure posted documents reflect current processes. 

16.  Using knowledge of CDM, coding and billing, collaborate with MIS, Revenue Cycle Team and Medical Records (HIM) managers, supervisors and staff to identify and document best practices for CCHC charge capture.  

17.  Maintain professional affiliations and attend seminars, conferences, etc.

18.  Attends and participates in educational programs, in-service meetings, workshops, and other activities as related to job knowledge and state guidelines.

19.  Performs other job related duties and assignments as requested.

 

Consistently provides service excellence to all patients, family members, visitors, volunteers and co-workers in a manner that reflects Cape Cod Healthcare's commitment to CARES: compassion, accountability, respect, excellence and service.

 

EDUCATION/EXPERIENCE/TRAINING:

  • Bachelors of Science preferred.
  • Minimum of one to two years experience in financial management in an acute care hospital
  • Experience with large hospital information systems required, preferably with Siemens Sorian.
  • Knowledge and expertise in the following areas:  hospital and physician billing requirements, CPT/HCPCS coding schemes and hospital and physician reimbursement methodologies.
  • Excellent interpersonal, problem solving, critical thinking and written skills.
  • Demonstrated ability to work effectively with department heads and supervisory staff.
  • Superior Excel Skills using Pivot Tables and other Advanced Functions, proficient use of Microsoft Project, PowerPoint and Visio desired.
  • Ability to work with minimum of supervision.

HR Use Only:


Zip Code: 02601
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