Job Type: Full-Time
Posted Date: Feb. 21, 2019
Work Shift: DAY
Work Week: M - F Specialized inpatient care for those patients requiring a longer hospital stay
Note: This position is located at our Continuing Care campus at: 701 S. Fry Road, Katy, TX 77450
System Denials Analyst analyzes all denials, write offs, and adjustments to identify net positive impactful opportunities at a facility and System-wide level that supports a focused response. The Analyst will communicate high dollar single opportunities as well as actionable trending to either specific facilities or across the System depending on the scope of the finding. The Analyst will maintain standardized reporting in centralized locations for all stakeholders in the process, as well as provide ad hoc reporting and data mining as findings dictate.
1. Communicates openly in a transparent and professional demeanor during all interactions with customers and co-workers.
2. Provides clear and concise communication of trending and findings to both front line team members and senior executives.
3. Demonstrates the components of the ICARE values statement.
4. Communicates in a time efficient and effective manner
5. Provides proactive updates on initiatives that involve time and effort from peers and other employees.
1. Communicates high dollar single opportunities as well as actionable trending to either specific facilities or across the System depending on the scope of the finding.
2. Participates in departmental and hospital performance improvement plan
3. Prioritizes opportunity for stakeholders based on financial benefit.
1. Completes monthly reporting accurately and timely in support of appropriate organizational response.
2. Reports accidents promptly and corrects minor safety hazards.
3. Complies with applicable laws, regulations, guidelines and standards regarding safety and infection control issues.
4. Follows all safety rules while on the job.
1. Performs data mining and reporting activities that identify net positive impactful opportunities in denials and adjustments for the individual facilities and the System. (daily)
2. Performs detailed reimbursement analyses independently and formulates appropriate modes of communication depending on the target population (regular activity)
3. Compiles and distributes denials and adjustment trending summaries to all stakeholders (weekly)
4. Schedules and maintains monthly taskforce appointments and attendee lists (regular activity)
5. Creates Denials Taskforce Meeting agendas (weekly)
6. Attends all business office and hospital based task force meetings (weekly)
7. Records minutes from task force meetings, including next steps and ownership (weekly)
8. Distributes summary of action items System-wide (monthly)
9. Ensures consistency of task force approach System-wide (weekly)
10. Acts as a liaison for issues affecting multiple hospitals to coordinate action items (daily)
11. Provides support when IT related or systematic changes are needed (regularly)
12. Owns System-wide Denials Tracker, ensures action items are updated timely (weekly)
13. Measures success of task force by trending denials data for resolved issues (weekly)
1. Seeks new and increasingly beneficial approaches to data mining and reporting to best support the ability of the System to respond to findings and trending.
2. Performs functions to complete action items utilizing available systems, as applicable.
3. Completes all hospital required and job related in-services and applies the information needed.
4. Performs audits of process and makes recommendations to denials leadership.
This position description is not intended to be all inclusive, and the employee will also perform other reasonably related business duties as assigned by the immediate supervisor and other management as required. The Houston Methodist Hospital reserves the right to revise or change job duties and responsibilities as the need arises.
High School Diploma
Bachelors degree in Finance or Health Administration preferred.
5 years of experience analyzing payer data and business office transactions in a healthcare setting.
CERTIFICATES, LICENSES AND REGISTRATIONS REQUIRED
SPECIAL KNOWLEDGE, SKILLS AND ABILITIES REQUIRED
- Strong analytical abilities and experience with application such as Access and Excel
- HIS experience preferred
- Microsoft Office Products preferred, including Microsoft Outlook
- Ability to manage multiple tasks at one time
- Ability to manage a fast-paced environment
- Strong ability to succinctly and accurately communicate high level trending and findings to executive leadership
Houston Methodist is an Equal Opportunity Employer.
Equal employment opportunity is a sound and just concept to which Houston Methodist is firmly bound. Houston Methodist will not engage in discrimination against or harassment of any person employed or seeking employment with Houston Methodist on the basis of race, color, religion, sex, sexual orientation, gender identity, national origin, age, disability, status as a protected veteran or other characteristics protected by law.
VEVRAA Federal Contractor – priority referral Protected Veterans requested.
Houston Methodist Continuing Care Hospital is the first specialty hospital in the Houston Methodist family. Located in the heart of the Katy community, the facility provides a special menu of services for both inpatient and outpatient care by team members called to serve with excellence and compassion:
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