About the Role Impact you will make A Revenue Opportunity Business Operations Analyst within Government Reimbursement will analyze and recommend solutions to Revenue Opportunity business problems.
The Analyst's primary responsibility will include completing all necessary research to identify claims eligible for adjustment and/or original billing.
Business Operations Analysts will need a high-level understanding within the industry and recognize FinThrive's acceptable quality standards as well as effectively communicate internally to ensure the highest standard of experience for our customers.
What you will do Ability to create projects in Government Reimbursement Manager Utilize Medicare Administrative Contractor (MAC) portals to complete Medicare Beneficiary Identifier (MBI) research Process projects through Revenue Opportunity Manager Preview return results to ensure projects have processed successful through Medicare Common Working File and HIPAA Eligibility Transaction System (HETS) Recognize discrepancies between current project and previous projects and alert leadership for further research Identify accounts within Government Reimbursement Manager that require research Research via MAC Interactive Voice Response (IVR) and/or Web Portal to identify potential reimbursable claims Contact Home Health Agencies and Skilled Nursing Facilities to verify level of patient care Review of patient medical records to identify transfers and receiving facility information Rebill accounts through Medicare Direct Data Entry (DDE) System Monitor claims returned or rejected to guarantee prompt correction and resolution Scrape Medicare DDE to identify payments, return to provider claims (RTP) and rejected claims Execute existing SQL queries to create monthly logs for Medicare Advantage patients Use CMS tools (pricer) to complete estimated additional reimbursements for eligible claims Establish and maintain login credentials for Medicare systems used by colleagues What you will bring 1+ years' experience in Healthcare Revenue Cycle Management 2+ years of experience in a healthcare related field Intermediate Microsoft Suite skills Strong analytical skills and ability to multi-task with diligence and accuracy Ability to interact effectively with peers. Proficient in communication, research, and critical thinking Ability to manage tasks independently, adapt workflow to meet FinThrive needs, work efficiently, take ownership of responsibilities, and meet deadlines. Proven ability to thrive in a team setting Excellent organizational skills Travel: Once per year What we would like to see Experience with Epic, Meditech, McKesson or Cerner EHRs and/or exposure to Healthcare Information technology Bachelor's degree Background in Medicare claims Experience standardizing and validating large data sets Ability to collect, organize, analyze, and disseminate significant amounts of information About FinThrive FinThrive is advancing the healthcare economy.
For the most recent information on FinThrive's vision for healthcare revenue management visit finthrive.com/why-finthrive.
Award-winning Culture of Customer-centricity and Reliability At FinThrive we're proud of our agile and committed culture, which makes FinThrive an exceptional place to work.
Explore our latest workplace recognitions at https://finthrive.com/careers#culture.
Our Perks and Benefits FinThrive is committed to continually enhancing the colleague experience by actively seeking new perks and benefits.
For the most up-to-date offerings visit finthrive.com/careers-benefits.
FinThrive's Core Values and Expectations Demonstrate integrity and ethics in day-to-day tasks and decision making, adhere to FinThrive's core values of being Customer-Centric, Agile, Reliable and Engaged, operate effectively in the FinThrive environment and the environment of the work group, maintain a focus on self-development and seek out continuous feedback and learning opportunities Support FinThrive's Compliance Program by adhering to policies and procedures pertaining to HIPAA, FCRA, GLBA and other laws applicable to FinThrive's business practices; this includes becoming familiar with FinThrive's Code of Ethics, attending training as required, notifying management or FinThrive's Helpline when there is a compliance concern or incident, HIPAA-compliant handling of patient information, and demonstrable awareness of confidentiality obligations Physical Demands The physical demands and work environment characteristics described here are representative of those that a colleague must meet to successfully perform the essential functions of this job.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
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All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability or protected veteran status.
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