OR/CVL Revenue Analyst

Location Address:

Compensation Pay Range:

Minimum Offer $:

Maximum Offer for this position is up to $:

Now hiring a

Summary:

Type of Opportunity:

Job Exempt:

Job is based :

Work Shift:

Responsibilities:

The person in this position will:

• Liaison to the Manager, Finance/Patient Financial Services, all hospitals, all PMG Sites, PHP, , Albuquerque Ambulance, Compliance and all HSL departments in addressing auditing, compliance and training issues and problems.
• Performs quality assurance audits of patient accounts for accuracy of information obtained during and after the admission process which includes but not limited to; patient demographics, complete and accurate insurance information, appropriate authorizations obtained, appropriate coding, accurate charges, identifying compliance and reimbursement related issues and accurate claims submission.
• Responsible for maintaining accurate, complete and timely documentation in electronic or hard copy form.
• Researches to the fullest extent and responds to inquiries and requests daily regarding auditing issues and problems and ad-hoc analysis for all PHS management.
• Identifies and disseminates solutions to audits by developing, implementing, and delivering knowledge, and technical training, for Presbyterian employees.
• Works with assigned business unit managers and staff to determine learning and training needs. Assesses the development and performance needs of the target audience.
• Develops learning and training materials, including participant workbooks, audio-visual materials, and facilitator guides.
• Identifies billing and collection practices that are inconsistent with contractual agreements and Government regulations.
• Summarizes findings with recommendations to Management.
• Identifies training needs regarding existing and new PHS guidelines. Works with Department Manager to ensure that new policies are incorporated.
• Assist with training by reviewing training material, critiquing the training class and communicating trends for re-training needs.
• Gathers and analyzes information to address and resolve business issues for a specific business group.
• Provides information to Management of discrepancies found.
• Maintain clear communication by responding to problems and inquiries via the telephone and e-mail.
• Maintains up-to-date working knowledge of all PHS business areas and IT applications.
• Participate in business unit meetings as an ad-hoc member to communicate trends and obtain up to date information.
• Assists in communicating and training HSL Staff on changes in procedures.
• Performs other functions as required.

Qualifications:

• Associates Degree or equivalent years of college level courses required. Relevent years of experience may be used in lieu of college degree/education.
• At least one year experience in healthcare related enterprise or Revenue Cycle business unit is Preferred.
• Critical thinking and extreme attention to detail.
• Excellent organizational, problem solving, verbal, written communication and ability to interact with other functional areas required.
• Systems operations knowledge of at least one patient accounting system (Medipac, EPIC or Horizon Home Health) and other revenue cycle systems. PC experience with Microsoft Office Word and Excel. Demonstrated ability to work effectively in a team environment. Medical terminology, Cardiovascular terminology, ICD-9, CPT-4 and HCPCS knowledge required

All benefits-eligible Presbyterian employees receive a comprehensive benefits package that includes medical, dental, vision, short-term and long-term disability, group term life insurance and other optional voluntary benefits.

Wellness
Presbyterian's Employee Wellness rewards program is designed to provide you with engaging opportunities to enhance your health and activate your well-being. Earn gift cards and more by taking an active role in our personal well-being by participating in wellness activities like wellness challenges, webinar, preventive screening and more.

Why work at Presbyterian?
As an organization, we are committed to improving the health of our communities. From hosting growers' markets to partnering with local communities, Presbyterian is taking active steps to improve the health of New Mexicans.

About Presbyterian Healthcare Services
Presbyterian exists to improve the health of patients, members, and the communities we serve. We are locally owned, not-for-profit healthcare system of nine hospitals, a statewide health plan and a growing multi-specialty medical group. Founded in New Mexico in 1908, we are the state's largest private employer with nearly 14,000 employees - including more than 1600 providers and nearly 4,700 nurses.

Our health plan serves more than 580,000 members statewide and offers Medicare Advantage, Medicaid (Centennial Care) and Commercial health plans.

AA/EOE/VET/DISABLED. PHS is a drug-free and tobacco-free employer with smoke free campuses.