Financial Access Analyst & Educator

Financial Access Analyst & Educator Location Renton, WA : Job Title: Financial Access Analyst & Educator Req: ******** Location: Remote Potential Department: Financial Advocate Shift: Days Type: Full Time FTE: 1 Hours: City State: Renton, WA Salary Range: Min $69,058 - Max $105,661/annual. DOE : The position description is a guide to the critical duties and essential functions of the job, not an all-inclusive list of responsibilities, qualifications, physical demands, and work environment conditions. Position descriptions are reviewed and revised to meet the changing needs of the organization.
TITLE: Financial Access Analyst & Educator
JOB OVERVIEW: The Financial Access Analyst & Educator is responsible for compiling and disseminating complete, accurate and consistent information regarding payor policy or procedure changes and/or other information that could impact reimbursement. This position will provide productivity & KPI metrics for quantity and quality surrounding Patient and Financial Access operations, by preparing detailed analytical and statistical reviews utilizing dashboard reports identifying delays that negatively impact the revenue cycle. Responsibilities include training curriculum development and educational content regarding payor policy and/or procedure changes to all staff areas affected promoting efficiency, accuracy, and compliance.
This role serves as a collaborator and subject matter expert. Work will be done with an EDI lens check in order to be culturally sensitive, considering and respecting different perspectives and motivations.
DEPARTMENT: Financial Access / Patient Access
HOURS OF WORK: 8:00 am to 4:30 pm, Monday - Friday (variable as needed)
REPORTS TO: Director, Financial Access
PREREQUISITES:
B.A. or B.S. degree is required. Relevant and applicable years of experience may substitute degree requirements.
Five (5) or more years of work experience in healthcare, preferably with a Patient Financial Services or Patient Access background, required.
Seven (7) or more years of EPIC experience required.
Three (3) or more years of experience in healthcare analytics required.
Extensive knowledge of payer eligibility, authorization, and reimbursement principles.
Demonstrated strong ability to communicate effectively in writing and verbally in the English language. Effective communication includes the ability to spell accurately and write legibly.
Ability to use various computer applications, including Microsoft Office, Excel, Word, PowerPoint, Visio, and Outlook. Level of Excel knowledge must be advanced to expert.
Proven analytical skills and problem-solving techniques.
QUALIFICATIONS:
Demonstrated experience in Patient Accounting applications as well as healthcare system applications, including Epic. SQL knowledge, at least to edit capability.
Knowledge of insurance practices and patient accounting functions, including insurance claims processing and third-party reimbursement procedures.
Knowledge of claim submission, insurance follow-up, charge capture/entry, and state and federal regulations as they relate to healthcare HIPAA and billing requirements.
Demonstrated experience in Patient Access revenue cycle management (i.e., payer plans, authorization, eligibility requirements, billing, and collection requirements whether managed care, fee for service, or government-sponsored plans).
Excellent communication skills with ability to listen actively and respond to fellow employees/customers in a timely, competent manner both verbally and non-verbally.
Ability to work in a professional manner, with a high level of patience, tolerance, and grace, with all departments throughout the organization.
Competent leadership skills, including the ability to coach, guide and present.
Ability to take initiative, work independently and make independent decisions.
Ability to organize/prioritize requests and work proficiently under pressure.
Ability to multitask, such as running queries while compiling reports and/or completing analysis.
Ability to perform functional assessments of departmental processes, recommend improvements and operational changes in policies and procedures.
Ability to maintain a high level of required administrative competencies and pursue continuing education as appropriate.
Effective written and oral communication with ability to follow written and oral instructions effectively.
Neat, well-groomed, professional appearance.
UNIQUE PHYSICAL/MENTAL DEMANDS, ENVIRONMENT AND WORKING CONDITIONS:
Must possess ability to work independently, with a minimum of direction, and take initiative in problem solving.
Must be able to interact professionally and effectively with a wide variety of people, including operations staff, providers, the general public, and departments in UW Medicine/Valley Medical Center (VMC).
Requires typing, legible handwriting and computer/keyboard skills.
Excellent telephone skills are essential.
Regular and punctual attendance is a condition of employment.
Requires the ability to maintain composure and a positive attitude under stress.
Requires problem solving and coaching ability and effective resolution of conflicts.
Must be able to function effectively in an environment with frequent interruptions and multiple priorities.
PERFORMANCE RESPONSIBILITIES:
A. Generic Job Functions: See Generic for Administrative Partner. B. Essential Responsibilities and Competencies
Responsible for compiling and disseminating complete, accurate and consistent information regarding payor policy or procedure changes and/or other information that could affect reimbursement to operations affected.
Responsible for KPI reporting across the VMC enterprise for all patient access, registration, scheduling, authorization & advocate staff to the team Manager or Director at least a monthly cadence.
Work on building and maintaining the KPI dashboards with IT on an as needed basis.
Responsible for maintaining and reporting OA initiative results to the CFO.
Responsible for working with departments on training curriculum development and deployment regarding payor policy, procedures, and other information that affects reimbursement.
Responsible for some elements of front-line training in Financial Access, Clinic Registration, PRC and more.
Maintains confidentiality of all protected health information.
Ensures regulatory compliance and JCAHO standards are reflected in all department policies and procedures.
Reports to the Director/Manager of Patient and Financial Access bi-weekly for review of the status of operations and key performance indicators.
Responsible for reviewing incoming payor bulletins and educating staff about new or changing contractual and regulatory requirements for all payers.
Maintains current knowledge of insurance plan updates to ensure that bills produced are compliant with Medicare, Medicaid, and other payer billing requirements.
Ensures VMC's billing activities comply with corporate, federal, and state fraud and abuse control programs.
Reviews and updates work processes to stay consistent with change. Monitors staff on comprehension of changes, training needs and provides training as needed.
Responsible for reviewing and escalating payor eligibility and benefit issues for staff and management.
Works to resolve registration issues regarding incorrect assignment of payor/plan codes and benefit plans.
Collaborates with Revenue Cycle departments, PFS, HIM, UM, and IT regarding database management issues.
Works with the IT Department and the PFS System Administrator to resolve system issues and implement system upgrades.
Continually influences, enhances, and improves the system through technical innovation and system utilization.
Responsible for recognizing and reporting technical issues to IT for resolution.
Provides ongoing evaluation of system to ensure compliance with regulatory agency requirements.
Assists in development and measurement of performance feedback information (e.g., edit and denial volumes, collection rates, etc.).
Works with Revenue Cycle management to identify denial trends; supports implementation of process improvements to reduce denials.
Collaborates with Revenue Cycle Leadership on staff comprehension and performance, and provides training as needed regarding compliance of HIPAA, Medicare/Medicaid, and other third-party payers and regulatory agencies.
Monitors new user performance in conjunction with appropriate management team.
Regularly reviews DNB and dashboard metrics to identify potential areas of delayed or lost revenue, and addresses areas of concern with management.
Prepares reporting documentation, validates data and audits for accuracy prior to distribution.
Identifies indicators and collects data used to analyze, monitor quality, measure effectiveness, and determine opportunities for improving Patient and Financial Access practices.
Collaborates with IT and Patient and Financial Access Leadership on development of workflows and Training in Practice (TiPs) training documents.
Assists in developing policies, procedures, and training materials related to responsible areas. Provides training as needed.
Seeks additional knowledge and skills appropriate to the position by participation in educational programs and activities, conferences, workshops, interdisciplinary professional meetings, and self-directed learning.
Provides coverage for Financial Access team members when staff is short or during surges in volume until the situation is stabilized.
Provides support for management's efforts to enhance the overall patient experience focusing on patients are First and improved patient satisfaction outcomes.
Participates in interdisciplinary teams that evaluate Revenue Cycle practices.
Represents Patient and/or Financial Access at meetings, both internal and external as requested.
Follows the Mission, Vision, and Values of Valley Medical Center. Performs all job functions in a manner consistent with Valley's cultural expectations defined as Valley Values. These characteristics include quality performance, demonstrating compassion, respect, teamwork, community-centered awareness, and innovation.
Completes additional projects and duties as assigned.
Date Created: 6/20
Revised: 12/22, 4/23
Grade: NCNM25
FLSA: E
CC: 8560
Job Qualifications: PREREQUISITES:
B.A. or B.S. degree is required. Relevant and applicable years of experience may substitute degree requirements.
Five (5) or more years of work experience in healthcare, preferably with a Patient Financial Services or Patient Access background, required.
Seven (7) or more years of EPIC experience required.
Three (3) or more years of experience in healthcare analytics required.
Extensive knowledge of payer eligibility, authorization, and reimbursement principles.
Demonstrated strong ability to communicate effectively in writing and verbally in the English language. Effective communication includes the ability to spell accurately and write legibly.
Ability to use various computer applications, including Microsoft Office, Excel, Word, PowerPoint, Visio, and Outlook. Level of Excel knowledge must be advanced to expert.
Proven analytical skills and problem-solving techniques.
QUALIFICATIONS:
Demonstrated experience in Patient Accounting applications as well as healthcare system applications, including Epic. SQL knowledge, at least to edit capability.
Knowledge of insurance practices and patient accounting functions, including insurance claims processing and third-party reimbursement procedures.
Knowledge of claim submission, insurance follow-up, charge capture/entry, and state and federal regulations as they relate to healthcare HIPAA and billing requirements.
Demonstrated experience in Patient Access revenue cycle management (i.e., payer plans, authorization, eligibility requirements, billing, and collection requirements whether managed care, fee for service, or government-sponsored plans).
Excellent communication skills with ability to listen actively and respond to fellow employees/customers in a timely, competent manner both verbally and non-verbally.
Ability to work in a professional manner, with a high level of patience, tolerance, and grace, with all departments throughout the organization.
Competent leadership skills, including the ability to coach, guide and present.
Ability to take initiative, work independently and make independent decisions.
Ability to organize/prioritize requests and work proficiently under pressure.
Ability to multitask, such as running queries while compiling reports and/or completing analysis.
Ability to perform functional assessments of departmental processes, recommend improvements and operational changes in policies and procedures.
Ability to maintain a high level of required administrative competencies and pursue continuing education as appropriate.
Effective written and oral communication with ability to follow written and oral instructions effectively.
Neat, well-groomed, professional appearance.