This position enhances efficient Revenue Cycle operations by providing oversight to the Provider Enrollment process by performing complex provider enrollment functions that facilitate billing for Professional/Provider services. The Business Analyst also monitors the overall process and identifies trends/issues that can be prevented or better managed to enhance the overall accuracy and timeliness of the provider enrollment workflow.
The Business Analyst also provides oversight to the University of Chicago Physicians Group (UCPG) Registration process by monitoring the charges/edits that fall to the WQâ™s and identifying trends/issues that could be avoided or better managed to enhance the accuracy and efficiency of the process.
The Business Analyst serves as a resource for questions about UCPG Provider Enrollment and Registration and works with others to share this information. In addition, this position works with both other UCPG Teams and Hospital Departments to provide information, troubleshoot issues and promote optimal operational workflows for assigned business unit.
Oversees the Provider Enrollment and Registration processes with minimal direct oversight, while also proactively reviewing current workflows for overall AR resolution with the intention to improve, implement, communicate and maintain an efficient Revenue Cycle process.
Identifies and resolves the systematic and/or operational root causes of Pre-AR Edits, A/R denials and outstanding AR.
Oversees and manages assigned Charge Router, Charge Review, Claim Edits, Retro and AR Follow-up work queues (WQ) and proposes both short and long-term enhancements that support business needs.
Assists manager with maintaining department scorecards/dashboards, creating documents and communicating with appropriate parties as needed.
Assists manager with utilizing audits/metrics in order to measure quality and ensure that Team members are performing work per defined standard.
Identifies training opportunities and conducts training as needed.
Works with Providers, Departments and payers to complete tasks needed for successful enrollment for billing or to troubleshoot and resolve issues that are causing edits in Pre-AR or denials/rejections for claims.
Creates simple to moderately-complex reports that are necessary for completing projects using a variety of business tools.
Communicates clearly and professionally with the other UCPG units, clinical departments, external vendors, and payers in effort to build partnerships that result in a high performing revenue cycle, denial resolution and prevention.
Provides AR follow-up expertise to other UCPG and University of Chicago Medicine (UCM) business units as needed.
Works closely with the Coding Education team to suggest opportunities for coder and provider training.
Assists clinical departments in resolving escalated AR and denial issues.
Works with Hospital Billing (HB) team on AR issues that cross between Epic PB, HB, or SBO applications.
Utilizes Operational Excellence tools to define standard work and identify root cause for defects in order to promote a high quality, high performing business unit.
Ability to provide Registration training to existing and new Pre-AR staff.
Ability to provide training related to Provider Enrollment workflows.
Ability to complete quality audits for Team activities.
Ability to create workflows and assists manager in developing and documenting policies and procedures.
Proven ability to effectively develop and introduce procedures and processes to others both within Department and with Manager/individuals in other UCM departments.
Demonstrated ability to participate as a member of a work group or team.
Demonstrated ability to set priorities and to effectively manage completion of assigned duties, with minimal supervision.
Demonstrated ability to communicate effectively in English, both orally and in writing.
Ability to solve problems independently with limited direction from the supervisor.
Ability to handle multiple concurrent tasks in a competent and professional manner in a fast paced atmosphere.
Education and Experience:
Bachelorâ™s degree or 8 years equivalent work experience required.
Previous experience with physician revenue cycle activities is required.
Previous experience with Provider Enrollment activities is preferred.
Previous experience with Patient Registration including assignment of Insurance coverage is required.
Previous experience with diagnosis and CPT coding terminology is preferred.
Previous experience using physician billing/revenue cycle software and electronic medical records systems is required.
Prior experience with Provider Enrollment software is preferred.
Previous experience with Epic Revenue Cycle Management software is required.
Previous experience with Microsoft Outlook, Word, and Excel is required. Use of PowerPoint and Visio is preferred.
Previous experience with Microsoft Excel cubes or related business intelligence software is preferred.
Previous experience with business workflow design and related policy/procedure development is preferred.
Previous experience with end User training for staff related to business workflows is preferred.
Previous experience with quality audits or workflow validation/testing is preferred.
Technical Knowledge or Skills:
Critical thinking skills to review/compare information and form conclusions is required.
Demonstration of effective interpersonal skills necessary to develop effective working relationships with both internal and external customers is required.
Reference Contact Information
NOTE: When applying, all required documents MUST be uploaded under the Resume/CV section of the application
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