Job Summary

Acts as a consultant for the Patient Financial Services Department by identifying, analyzing and resolving complex internal and external operational issues in order to maximize CAMC Health System's revenue cycle.

Responsibilities

• Analyzes policy requirements, procedures and methods, work flow, error deduction and correction.
• Examines accounts receivable trends to identify critical areas for improvement. • Determines the cost and benefits of making changes in operations and accounts receivable management and documents conclusions and recommendations for management.
• Utilizes and/or develops database management and automated financial analysis applications to support conclusions and recommendations.
• Develops operational procedure changes. Plans and coordinates the introduction and implementation of the changes.
• Responsible for the development of conversion procedures. Trains the Patient Financial Services Supervisors and their employees, and provides the necessary documentation to support new or revised procedures.
• Performs follow-up audit procedures to identify and resolve any operational problems.
• Responsible for performing complex systems analysis of the Accounts Receivable, Patient Access, and Third Party Billing data communication system and ensuring the effectiveness of each.
• Represents the Patient Financial Services areas in the analysis, evaluation, planning, and implementation of the various data communication systems within the hospital that interface with the Accounts Receivable/Third Party Billing systems and any other systems used within the departments.
• Confers with Federal, State, and Third Party insurance agencies, and software vendor support personnel in order to ascertain, clarify, and develop solutions, automated and manual, to meet third party billing data and format requirements.
• Maintains an ongoing, professional relationship with various departments and individuals within CAMC in order to accomplish the daily objectives of the Patient Financial Services Department.
• Required to act as a liaison between CAMC and third party payers in cases where it is necessary to meet and discuss contractual agreements, issues, provider updates and or changes.
• Troubleshoots problems in regards to claims, proactively working to identify the potential of workflow problems.
• Writes/programs reports needed in various databases, depending on the type of data required for reporting and/or analysis.
• Handles requests from management, supervisors, and staff in regards to analyzing issues with claims, isolating and resolving problems with systems.

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.

Education 

• Bachelor's Degree

Credentials 

Work Schedule: Days

Status:  Full Time Regular 1.0

Location: General Hospital

Location of Job: US:WV:Charleston

Talent Acquisition Specialist: Tamara B. Young tammy.young@vandaliahealth.org