Patient Accounts Operations/Systems Quality Analyst

As a Patient Accounts Operations/Systems Quality Analyst, you will analyze accounts, processes and systems to find root causes of defects. Under minimal supervision, supports the Patient Account Quality Assurance activity for the Hospitals with an Emphasis on ensuring that billing (focused Governmental and Non-Governmental) processes are in compliance and on operational activities for management and clerical staff (all patient account department functions). Works as primary analysts and testing support on Patient Accounting and Clinical systems module/step installations, upgrades and fixes; working with IT and operations resources. Works on projects for Patient Accounting and Clinical systems to support activities related to Medicare, Medicaid and all third party billing and collection of claims. Assists in overseeing the patient accounting and revenue cycle areas including charge entries, bill holds, coding initiatives, forms and data capture, etc. Reviews and makes recommendations on patient account and revenue cycle procedures/policies as they pertain to quality assurance. Is involved with external patient accounting audits, gathers and interprets government, state and private payer regulations. Reviews hospital enrollment statuses and reviews admission, billing and collection practices as appropriate. Assists with analysis of, tracking of and review of all internal/external audit requests. Serves as liaison to other hospital departments regarding policy and procedure interpretation as it relates to efficient Medicare, Medicaid, dual eligibility, State and federal HMO’s and all third party regulations, reimbursement and ensures patient accounts processes and procedures are in place and adhered to. Works with Revenue Cycle Management in assigning the appropriate billing codes and initiates changes to facilitate the all billing processes.