Reimbursement Analyst
US-CA-Rancho Cordova
commonspirit_careers
Req #: 461940
Type: Day
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Overview: Dignity Health Medical Foundation, established in 1993, is a California nonprofit public benefit corporation with care centers throughout California. Dignity Health Medical Foundation is an affiliate of Dignity Health - one of the largest health systems in the nation - with hospitals and care centers in California, Arizona and Nevada. Today, Dignity Health Medical Foundation works hand-in-hand with physicians and providers throughout California to provide comprehensive health care services to the many communities we serve. As Dignity Health Medical Foundation continues to grow and establish new premier care centers, we provide increasing support and investment in the latest technologies, finest physicians and state-of-the-art medical facilities. We strive to create purposeful work settings where staff can provide great care, while advancing in knowledge and experience through challenging work assignments and stimulating relationships. Our staff is well-trained and highly skilled, qualities that are vital to maintaining excellence in care and service. Responsibilities: As a Reimbursement Professional, you will be a pivotal expert, optimizing financial outcomes through accurate, timely, and compliant claim processing. Every day, you'll meticulously manage and analyze complex reimbursement methodologies, payer contracts, and regulatory requirements to maximize revenue and minimize denials. You'll identify trends, appeal claims, and collaborate with departments and payers to resolve discrepancies, implementing efficient billing practices. To be successful, you'll combine strong analytical skills with a deep understanding of healthcare finance, meticulous attention to detail, and exceptional problem-solving and communication abilities, transforming reimbursement challenges into strategic financial advantages. * Demonstrate a solid understanding of healthcare accounts receivable. Working knowledge of Payor Rules & Regulations, Understanding contract language, CCI Coding Issues, Read and interpret DOFR. * Ability to determine correct systems to locate pertinent info which may include; IDX,MPV, Medical Records Systems, Insurance Payor Web Sites, Code Correct Web Site * Demonstrate strong analytical skills in daily duties. * Ability to demonstrate thorough knowledge and understanding when communicating with peers as well as internal and external customers. * Ability to manage multiple expectations, task and deadlines effectively. * Timely review of electronic communication to stay informed of changes that affect your position. Qualifications: * High School Diploma or GED * Five years experience working in healthcare revenue cycle and/or a professional medical billing office * One year experience with IDX Practice Management System required * Knowledge of physician billing regulations * Understanding of professional claims and billing procedures * Strong MS Excel skills to interpret and analyze high volume of data * Strong analytical skills to identify key issues from large amounts of detailed data. Perform root cause analysis to determine origin of issues with the aim of correction * Ability to build and maintain working relationships with all levels of staff, physicians and other contacts Preferred Qualifications: * Six years experience working in healthcare revenue cycle, in a professional medical billing office as well as experience in reviewing and interpreting contracts * One year experience with IDX Practice Management System.
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