Cooper University Health Care

Healthcare Access Quality Analyst

Cooper University Health Care$70K — $116K *
Healthcare
Less than 5 years of experience
Job Overview by Ladders

Qualifications

  • 4+ years in hospital, ambulatory, patient access, or related revenue cycle experience
  • Experience researching, collecting, and presenting data
  • Proficient in Microsoft Office and knowledgeable in ICD-10, CPT codes, HCPCS codes
  • Proficient in Epic User Web/Optimization
  • Strong interpersonal and writing skills; capable of managing multiple projects
  • Bachelor's Degree preferred
  • HFMA or equivalent certification preferred

Responsibilities

  • Manage HCA registration compliance integrity system to enhance departmental performance
  • Analyze denial data to detect trends and propose remediation plans
  • Communicate denial metrics and workflow opportunities to leadership
  • Review Notice of Admission submissions for payer compliance
  • Analyze IP Only CPT codes to ensure proper authorizations
  • Develop Medicare Compliance Executive Summaries and collaborate on compliance trends
  • Collaborate with IT and Revenue Cycle University for process optimization

Benefits

  • Opportunity to work in a collaborative environment
  • Exposure to various aspects of revenue cycle management
  • Role as a Subject Matter Expert on HCA topics
  • Engagement in ongoing professional development and training
  • Ability to influence departmental performance and compliance initiatives
Full Job Description
Short Description

Manages comprehensive HCA registration compliance integrity system and works toward goals and objectives for optimizing departmental performance and denial mitigation. Has a sound understanding of the payor policies related to denials and appeals process for denials deemed within Healthcare Access scope.

  • Reviews and analyzes denial data for all denials occurring within the scope of HCA to determine denial trends and helps develop remediation plans and/or workflow resolutions.
  • Presents denial metric driven information and workflow opportunities to Healthcare Access Leadership
  • Reviews and analyzes Notice of Admission submission to ensure we are submitting within payer driven requirements.
  • Analyze IP Only CPT codes for scheduled procedures to help identify best practice to identify and ensure proper authorization is obtained for the CPT code and site of service.
  • Develop and maintain Executive Summary for Medicare Compliance Reports and collaborate with leadership on trends and opportunities for compliance within the IMM, MOON, and MSPQ collection process.
  • Collaborate with Epic IT to ensure optimization of Epic Registration Dashboards for quality and productivity.
  • Collaborate with Revenue Cycle University to develop annual CLN’s and quality assurance processes for all HCA Team Members.Develops and monitor EPIC reports and work queues to ensure timely response to denied cases and appeals and provides follow-up on cases until resolution has been achieved.
  • Evaluate trends found in Epic DNB, Claim Edit, and Patient work queues and help develop remediation plans for leaders to deliver to front end users.
  • Assist in the on-going support of data collection, analyzation, and developing/implementing new strategies to ensure an effective registration process.
  • Participate in development of documents to drive quality improvement, including the design of quality monitoring forms and quality standards. Document and update policy, process, procedures, guidelines, and training materials.
  • Develops and maintains positive, collaborative, supportive working relationships with all members of the organization.
  • Serve as a Subject Matter Expert on all areas within the scope of HCA. Provides support to all HCA in Camden and Cape May. All other duties as assigned by HCA Leadership
Experience Required
  • Minimum four years99 experience preferred in hospital, ambulatory, patient access, or related revenue cycle experience.
  • Demonstrated ability to research, collect, and present information.
  • Strong computer skills; proficiency with Microsoft Office suite. Thorough understanding of ICD-10, CPT codes, HCPCS codes. Epic User Web / Optimization skills required.
  • Excellent interpersonal skills as well as superior writing skills. Deadline oriented; ability to work independently and in a team environment. Ability to manage multiple complex and concurrent projects.
Education Requirements

Bachelor99s Degree preferred.

License/Certification Requirements

HFMA certification or equivalent certification in NAHAM, AAHAM preferred.

Special Requirements
  • Healthcare experience preferred.
  • Knowledge of Payor Portals & Policies
  • Knowledge of EPIC account, patient, and referral wqs
Salary Min ($)USD $34.00 Salary Max ($)USD $56.00

About Cooper University Health Care

Cooper University Health Care is a leading academic health system and the only state-designated Level 1 Trauma Center in South Jersey. With more than 7000 employees, Cooper is committed to excellence in patient care, education, research, and community outreach. Cooper has more than 630 physicians in over 75 specialties, with a network of more than 100 medical offices and four urgent care centers throughout the region. Cooper is affiliated with Cooper Medical School of Rowan University, and is a member of the Jefferson Health System.
Learn more about Cooper University Health Care
Size
7,000 employees
Industry

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