Financial Analyst, Revenue Integrity

Job Summary

 Collect and prepare financial data, analyze fiscal accounting and related systems to effectively and efficiently report various aspects of financial activities and financial position of the MSO's clients.

Reviews claims and payment data to ensure accurate billing to and payments from all Commercial, Managed Care and Governmental Payers to ensure compliance with all payer contracts and fee schedules. Reviews, researches and documents trends with a focus on identifying charging and documentation opportunities. 

Responsibilities

Prepare financial feasibility studies, review/evaluate studies, and administrative planning studies as assigned.

 • Prepare, analyze and maintain financial data as required for financial reporting, budgets and forecasting.

 • Analyze financial operation of physician practices, prepare recommendations and documentation to create and update fiscal service and other related policies and procedures with respect to accounting systems. 

• Conduct and assist in the presentation of fiscal educational sessions to prospective clients. 

• Accumulate and maintain detailed records of clients' assets, liabilities revenues, and expenses as assigned. 

• Periodically review client contracts; vendor, payor, etc.

 • Assist Director and/or Finance Manager with special projects as assigned

 • Attend meetings as required and participate on committees as requested.

 • Enhance professional growth and development through inservice meetings, educational programs, seminars, conferences, workshops, etc. to keep abreast of trends and changes in the field.

• Work closely with Payer Contracting Department to ensure accurate rates and payment terms are loaded in company-approved contract management systems used to monitor billing and payment activity
• Ensure claims and payment data is loaded into company-approved claims and payment monitoring systems and resolve any discrepancies in a timely manner
• Monitor to ensure payments from contracted payers are timely and within contracted payment terms
• Review reimbursement and variance reports to identify trends and discrepancies
• Prepare detailed non-payment/underpayment reports and distributed to appropriate teams for appropriate resolution and follow up
• Review denial reports to identify trends and recommend solutions
• Use Company approved charge capture auditing systems to identify missed charges and work closely with various departments to resolve issue
• Attend meetings as required and participate on committees as requested
• Enhance Professional growth and development through in-service meetings, educational programs, seminars, conferences, workshops, etc.
• Perform other duties and responsibilities as assigned

Knowledge, Skills & Abilities

Patient Group Knowledge (Only applies to positions with direct patient contact)
The employee must possess/obtain (by the end of the orientation period) and demonstrate the knowledge and skills necessary to provide developmentally appropriate assessment, treatment or care as defined by the department’s identified patient ages. Specifically the employee must be able to demonstrate competency in: 1) ability to obtain and interpret information in terms of patient needs; 2) knowledge of growth and development; and 3) understanding of the range of treatment needed by the patients.
Competency Statement
Must demonstrate competency through an initial orientation and ongoing competency validation to independently perform tasks and additional duties as specified in the job description and the unit/department specific competency checklist.
Common Duties and Responsibilities
(Essential duties common to all positions)
1. Maintain and document all applicable required education.
2. Demonstrate positive customer service and co-worker relations.
3. Comply with the company's attendance policy.
4. Participate in the continuous, quality improvement activities of the department and institution.
5. Perform work in a cost effective manner.
6. Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations.
7. Perform work in alignment with the overall mission and strategic plan of the organization.
8. Follow organizational and departmental policies and procedures, as applicable.
9. Perform related duties as assigned.

• Maintain and document all applicable required education.
• Demonstrate positive customer service and co-worker relations.
• Comply with the company's attendance policy.
• Participate in the continuous, quality improvement activities of the department and institution.
• Perform work in a cost effective manner.
• Perform work in accordance with all departmental pay practices and scheduling policies, including but not limited to, overtime, various shift work, and on-call situations.
• Perform work in alignment with the overall mission and strategic plan of the organization.
• Follow organizational and departmental policies and procedures, as applicable.
• Perform related duties as assigned.

Education

• Bachelor's Degree (Required) Bachelor's Degree in Accounting, Business, Finance, or related field Level of Experience - 3+ years of related experience; Grant or sponsored project experience preferred

• Bachelor's DegreeExperience: 2 years related financial/accounting experience Substitution: 10 years related experience working in a Patient Accounting related position and 2 years’ experience working in an analytical role may substitute for Bachelor's Degree and 2 years financial/accounting experience

Credentials 

• No Certification, Competency or License Required
• Healthcare Financial Management Association All licensure must be current/valid and from the state of West Virginia. Driver's License

Work Schedule: Days

Status:  Full Time Regular 1.0

Location: General Hospital

Location of Job: US:WV:Charleston

Talent Acquisition Specialist: Lisa J. Craft lisa.craft@vandaliahealth.org