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CBO Contracts and AR Analyst- Business Office
This position is: Full Time
Position Location: Lake Charles, LA

Essential Function: The CBO Contracts and AR Analyst position serves as the subject matter expert on the Contract Management application and is responsible for the following functions that include but are not limited to: Contract Management application maintenance of all CBO contract profiles, new contracts, current contract updates and revisions and maintenance of all CBO contract hardcopies. This position is also responsible for the analysis of the visits/accounts potentially underpaid by Government and Non-Government payors. The analyst will provide detailed review results to the Patient Accounting management team as well as the staff in order to contest true underpayments at a payer level and to manage denial resolution workflows.

Supervision: Billing and Collections Manager

Job Responsibilities:

1. Serves as a (SME) subject matter expert for the Contract Management (CM) application functionalities and reporting capabilities. Also responsible for the maintenance of all CBO contract profiles so that they remain up to date at all times to ensure proper reimbursement expectations are tracked and any payment deficiencies identified.

2. Utilizes the Contract Management tool to review and analyze potential underpaid visits/services against payer contract terms and conditions.

3. Compiles daily/weekly/monthly reporting to analyze and track data and provide feedback to Management and Patient Accounting staff related to AR payment trends and denials.

4. Documents visits/accounts with attention to detail and thorough explanation as to the findings for the difference in expected reimbursement.

5. Escalates any Contract Management issues same day as identified and notifies Management team of resolution, if applicable.

6. Completes and submits all Contract Management support case requests to the vendor for contract profile revisions, deletions or new data input and monitors the requests for timely and accurate completion in Contract Management application

7. Collaborates with all Imperial Health external offices if underpayments are related to charges and services rendered.

8. If applicable, provides training to Patient Accounting Representatives on how to identify underpayment issues.

9. Responsible for adding new codes to the Fee schedules and updating Charge Master files

10. Maintains GE EDI data and GE Tables:

Insurance Carrier/Group Tables and Transaction Column Sets

Responsible for EDI Submission Management (uploading/transmission of daily claims)

Monitor claims upload/transmission reporting

Add new referring physicians to provider table and referral source table

Add new Employers, Guarantors, or Zip Codes to GE as needed

11. Other duties as assigned

Requirements:

Qualifications:

Knowledge of:

Healthcare Billing practices and Payor reimbursement procedures

Accurately interprets all Government, Commercial, Managed Care contracts terms and conditions

Ability to:

  • work independently, effectively and with minimal supervision
  • intermediate to advance proficiency with healthcare technology applications
  • work effectively with personnel at all levels and promote teamwork

Skilled in:

  • Must possess excellent discretionary judgment and good organizational skills as well as excellent verbal and written communication skills.
  • Must be able to work with sensitive information in a professional and confidential manner. Must be able to relay information accurately in telephone conversations, messages, email, and other forms of communication.

KNOWLEDGE, SKILLS & ABILITIES:

  • Microsoft Office: Must be proficient in Word and Excel
  • Proficient skills in typing and 10 key by touch.
  • Advanced analytical skills

EDUCATION REQUIREMENTS:

High School graduate or equivalent

EXPERIENCE:

  • Minimum of 3 years experience or more in Healthcare Billing and Collections for contracted commercial and government payors;
  • Minimum of 2 years experience in a professional/medical office setting

ENVIRONMENTAL/WORKING CONDITIONS: Office setting. Frequent telephone calls and other interruptions, which requires being able to handle a fast-paced work environment during entire time at work. Must be able to prioritize multiple projects. Must maintain strict confidentiality and exercise professionalism when interacting with staff, managers, supervisors, physicians, external customers, etc.

PHYSICAL/MENTAL DEMANDS: requires continuous standing, sitting, frequent walking, bending, and stooping. May require lifting 50 to 100 pounds. Exposure to possible Hazardous Materials/conditions and infectious diseases.


 

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