Job Summary This Revenue Integrity Data Analyst will be responsible to:
Perform data analyses. Identify data trends in order to accomplish department goals and objectives. Compile, extract, and analyze denials reports directly out of Epic in order to deliver trends to root cause owners and denials steering committee.
Analyze charge capture and reconciliation data and provide trending information on missed and inaccurate charging. Monitor and correct inaccuracies routed to revenue integrity work queues. Responsible for correcting assigned errors and clearing work queues regularly. Proactively communicate issue identification and resolution status to stakeholders. Escalate issues appropriately to Revenue Integrity Specialists.
Maintain reports and dashboards. Compile, reconcile and distribute dept reports timely to the appropriate teams and clinical leadership.
Support Revenue Integrity audit function by validating data through researching anomalies and cross-referencing data with other systems.
Serve as technical analytics support to Revenue Integrity staff on Epic and Microsoft applications.
Provide feedback on feasibility and impact of procedural changes.
Assist with ensuring compliance and achievement of BCH Clinic financial goals (i.e., appropriate internal controls).
Builds and maintains a thorough knowledge of payer rules, regulations, policies and procedures as they relate to and impact the billing process. Serves as subject matter expert and updates faculty and staff as needed.
Knowledge of pre-service financial clearance responsibilities. Specifically, knowledge and execution of prior authorization workflows and insurance subject matter expertise.
To qualify, you must have:
A High School diploma or equivalent and 2 years of exp in a hospital decision support or database management role are required. A Bachelor's degree in Healthcare or Finance related discipline is preferred.
A Coding certification is preferred, e.g. CCA, CCEP, CCS, CCS P, COC, CHC, CHFP, CPC, CRCM, RHIT, RHIA, etc.
Proficiency in business intelligence applications including SQL (SQL server or Oracle) and visualization engines
Working knowledge of financial, clinical, and Accounts Receivable business processes and data flow in hospital environment
Working knowledge of Cerner Clinical applications and Epic modules and applications (e.g. Charge Router, Clarity reports, Worklist, etc.)
Advanced knowledge of Microsoft applications including Word, Excel, Visio, Data visualization tools Outlook and PowerPoint
Analytical skills to gather and interpret data in situations in which the information or challenges are relatively routine
Attention to detail, good organizational skills, ability to meet priorities within set timeframes, and ability to work as part of a team
Strong written, verbal, analytical and communication skills
Boston Children's Hospital offers competitive compensation and unmatched benefits including flexible schedules, affordable health, vision and dental insurance, child care and student loan subsidies, generous levels of time off, 403(b) Retirement Savings plan, Pension, Tuition and certain License and Certification Reimbursement, cell phone plan discounts and discounted rates on T-passes. Experience the benefits of passion and teamwork.
Boston Children's Hospital is a 395-bed comprehensive center for pediatric health care. As one of the largest pediatric medical centers in the United States, Children's offers a complete range of health care services for children from birth through 21 years of age.