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Managed Care Financial Analyst. 40hrs. Days.

Company: MetroWest Medical Center
Location: Natick
Posted on: November 11, 2019

Job Description:

Description: General Summary: Responsible for Managed Care reimbursement compliance. Assists Director in special projects. Principal Duties & Responsibilities:1.Maintains and monitors the following Sharepoint logs: Media, Rebills, EOB Request & QS.2.Assist Director in the review of adjustments posted to individual patient accounts.3.Assists Director with special projects.4.Ascertain patient accounts balances are correct prior to being written off to Medicare bad debt.5.Provides support during the month-end close process, including analysis related to credit balances and assistance in the determination of contractual allowances.6.Provides continuous communication and feedback to business units for process Improvement initiatives and to reduce days outstanding.7.Reviews collections of all outliers, high cost pass through items and carveouts as per stated in the contracts.8.Responsible for posting up front cash before 12:00 noon daily.9.Prepares Daily Cash Reconciliation spreadsheet and submits it to the RBO.10.Maintains daily communication with the Finance Department regarding posting variances.11.Perform other assigned duties as assigned. Qualifications: Knowledge, Experience and Other Job Requirements: Education High School Diploma required and some college preferred. Skills and Abilities Effective oral and written communication skills; Strong analytical skills; Strong interpersonal skills; High aptitude for understanding and using Hospital Patient Accounting Systems and other related software. ExperienceFive (5) or more years accounts receivable experience preferably in hospital setting. Experience with automated patient accounting systems and electronic billing systems. Managed Care background. Strong working knowledge of third party billing and collection requirements to include Medicare, Medicaid, commercial and Managed Care Payers. Working knowledge of all Business Units, including Patient Access, HIM, Case Management and Finance. Familiar with DNFB, FBNE, DNSP and APC Edits to monitor and resolve unbilled accounts report for outstanding and/or uncoded patient encounters to reduce accounts receivable days. Performs data quality reviews on patient encounters to validate the ICD-9-CM, CPT, and HCPCS Level II code and modifier assignments, APC group appropriateness, and ensure compliance with all APC mandates and outpatient reporting requirements. Job: Finance and Accounting Primary Location: Natick, Massachusetts Facility: MetroWest Medical Center Job Type: Full-time Shift Type: Days Employment practices will not be influenced or affected by an applicant's or employee's race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship. Tenet participates in the E-Verify program. Follow the link below for additional information. E-Verify: *****************************

Keywords: MetroWest Medical Center, Boston , Managed Care Financial Analyst. 40hrs. Days., Professions , Natick, Massachusetts

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