Posted: Wednesday, November 8, 2017 7:05 AM
1000 Remington Boulevard, Bolingbrook, IL United States (US)
Daily Hours: 8
Standard Hours: 40
The Revenue Cycle Contract System Analyst is responsible for developing, testing and maintaining proration rules to net patient accounts down to expected reimbursement in the host system at time of billing. Coordinates with other Presence Health departments to ensure that proration rules are up:to:date and accurate.
ESSENTIAL DUTIES AND RESPONSIBILITIES
:Designs, develops, tests and implements proration rules contractual adjustments to patient accounts at the time of bill creation.
:Plans, tests, and executes the implementation of new or amended contracts in collaboration with PFS management and staff, Information Systems, Managed Care, and other affected departments.
Maintains Proration Issue/Update Log and Proration Rule updates/new rules to facilitate communication during update meetings with other departments by inputting, researching and resolving issues identified on the log. Obtains confirmation that the issue was resolved from PFS before marking the issue complete.
Maintains a schedule of key update dates for proration rules, such as Medicare OP quarterly updates, yearly Diagnostic Related Group (DRG) updates, and yearly increases for the Managed Care contracts. This schedule will be used by an internal Proration Department to schedule updates and by other departments to be aware of update dates.
:Responds to inquiries from PFS user regarding questions related to the proration adjustments and expected reimbursement by educating and explaining proration logic.
To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.
Education and/or Experience
Bachelors degree in Business, Information Systems or Health Care Management with either one year of directly related experience in creating proration rules or healthcare contract management or two years of directly related experience in programming with healthcare experience; Or, High School diploma or GED and five years of directly related experience in creating proration rules, healthcare contract management or programming with healthcare experience.
Must be an expert in proration methods and have an in depth understanding of Managed Care contracts and Government payors and have excellent verbal, written, analytical, interpretive and time management skills.
Advanced knowledge of Microsoft Office products, especially Excel and Access required.
Experience with Meditech and EPIC patient accounting systems, MUMPS programming language or similar programming language, Boston Workstation, and Monarch reporting/data mining software is preferred.
Business Unit: Corporate (LRHC and LPH)
Department Name: RC Analytics
• Location: bolingbrook, Chicago
• Post ID: 81107152 chicago