Resource Planning Analyst (HS)
4.
0 Full-time 3 hours ago Full Job Description SCOPE OF POSITION:
The Revenue Cycle Clinical Support Office (RCCS) is an area within Access and Revenue Cycle Management Shared Services responsible for managing the Health System's Denials, UH/Ross Clinical Pre-certification, Case reviews, In-Patient claims, Medicare A to B Billing, and supporting Utilization Management to ensure requirements are met.
RCCS is also responsible for responding to Government, Commercial and Internal audits.
RCCS provides extensive reporting to Senior Leadership on these areas.
The Health System includes all facility billing for University Hospital, Ross Heart Hospital, University Hospital East, The Arthur G.
James Cancer Hospital, OSU Harding Hospital, and Dodd Hall Rehabilitation.
RCCS interprets payer requirements and develops processes to obtain clinical precertification and aggressive appeal arguments in collaboration with physicians.
Claims are reviewed and edited to ensure accurate billing.
Information Technology and Reporting are leveraged to efficiently manage the extensive volume of claim activity to ensure timely processing of claims.
RCCS is integral to the support of a successful/health and compliant revenue cycle.
It is responsible for bringing in cash to support the financial bottom line, keeping days in Accounts Receivable low, maintaining efficient/effective operations, and supporting patient friendly experiences.
The Resource Planning Analyst (RPA) provides administrative and analytical support to the Director and Management team in RCCS.
The Resource Planning Analyst (RPA) position is responsible for resolving issues related to authorizations, utilization review requirements, billing, and compliance within the revenue cycle for OSU Health System through using quantitative and qualitative analysis techniques.
The RPA supports OSU Health System in meeting objectives of a successful and compliant revenue cycle through increasing cash on hand, lowering AR days, and lowering rejections/denials.
This position provides support, intervention, and follow-up on a variety of processes that impact the revenue cycle including authorization review, analysis, and combining/uncombining accounts.
This position supports Utilization Management as well as Revenue Cycle Clinical Support (RCCS) along with communication with the different payers.
The overall goal of the department is to insure compliance to billing regulations yet also insure a payment.
POSITION
Summary:
The Resource Planning Analyst is responsible for a wide variety of functions.
Daily functions revolve around analyzing and resolving issues with accounts that involve authorization, utilization review, billing, and compliance.
This position is responsible for independently monitoring and ensuring that utilization review has been completed on all hospitalizations.
Serves as an expert in understanding the payers' requirements and works with various other departments to identify issues and resolve them.
Responsible for independently providing a higher-level review of denials to determine a root cause.
Analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials.
This position uses expert knowledge of payer requirements to write appeals for administrative authorization denials.
Identifies and develops appropriate tools to track issues, analyzes workflows, identifies logistical and operational issues to target for improvement.
Responsible for reviewing accounts with various claim errors that require higher-level review.
This can include claims with admission or discharge date discrepancies, admission order timing issues, or various other regulatory compliance issues.
Responsible for interdepartmental/intradepartmental communication and process improvement throughout the revenue cycle.
Must become competent in all available systems where revenue cycle information is held.
Organizational Expectations Practices within the Medical Center's policies and procedures.
Adheres to the Intensive Caring Value statements as demonstrated through positive patient/guest relations, positive and effective interactions with staff and formulating and meeting developmental goals.
Minimum Qualifications Qualified candidates should have a bachelor degree in healthcare administration or appropriate closely related field.
Knowledge of all aspects of the revenue cycle is considered extremely helpful:
(scheduling, patient flow through the system for inpatient and outpatient, patient placement, charge entry, billing).
Operational knowledge of the primary revenue cycle systems (EPIC) along with systems processes and design preferred.
Experience with Excel, Access, OneNote, and PowerPoint is required.
Ability to synthesize information and concisely communicate either verbally or in writing is essential.
Ability to work well under pressure.
Ability to demonstrate independence, self-initiative, thoroughness, and attention to detail.
Job Description Functions as integral member of the health care team to reflect the culture of cooperation, enthusiasm and respect.
Implement strategies to enhance the strategic plan of the Medical Center to improve access and services to our customers and to ensure reimbursement of hospital services.
Responsible for monitoring and insuring the accuracy of registration errors through a series of reports, correcting errors, collecting and coordinating QA and developing reporting mechanisms for various groups.
Insure that errors are corrected in a timely manner prior to bill drop.
Solve problems related to the various issues identified through this process and consistently progress toward improving the reasons why things happen.
Position located at University Hospitals.
Minimum Education Required:
Bachelor's Level Degree or equivalent combination of education and experience.
Required
Qualifications:
Bachelors degree in appropriate field or equivalent combination of education and exp.
Regular 40 First Shift.
Estimated Salary: $20 to $28 per hour based on qualifications.
0 Full-time 3 hours ago Full Job Description SCOPE OF POSITION:
The Revenue Cycle Clinical Support Office (RCCS) is an area within Access and Revenue Cycle Management Shared Services responsible for managing the Health System's Denials, UH/Ross Clinical Pre-certification, Case reviews, In-Patient claims, Medicare A to B Billing, and supporting Utilization Management to ensure requirements are met.
RCCS is also responsible for responding to Government, Commercial and Internal audits.
RCCS provides extensive reporting to Senior Leadership on these areas.
The Health System includes all facility billing for University Hospital, Ross Heart Hospital, University Hospital East, The Arthur G.
James Cancer Hospital, OSU Harding Hospital, and Dodd Hall Rehabilitation.
RCCS interprets payer requirements and develops processes to obtain clinical precertification and aggressive appeal arguments in collaboration with physicians.
Claims are reviewed and edited to ensure accurate billing.
Information Technology and Reporting are leveraged to efficiently manage the extensive volume of claim activity to ensure timely processing of claims.
RCCS is integral to the support of a successful/health and compliant revenue cycle.
It is responsible for bringing in cash to support the financial bottom line, keeping days in Accounts Receivable low, maintaining efficient/effective operations, and supporting patient friendly experiences.
The Resource Planning Analyst (RPA) provides administrative and analytical support to the Director and Management team in RCCS.
The Resource Planning Analyst (RPA) position is responsible for resolving issues related to authorizations, utilization review requirements, billing, and compliance within the revenue cycle for OSU Health System through using quantitative and qualitative analysis techniques.
The RPA supports OSU Health System in meeting objectives of a successful and compliant revenue cycle through increasing cash on hand, lowering AR days, and lowering rejections/denials.
This position provides support, intervention, and follow-up on a variety of processes that impact the revenue cycle including authorization review, analysis, and combining/uncombining accounts.
This position supports Utilization Management as well as Revenue Cycle Clinical Support (RCCS) along with communication with the different payers.
The overall goal of the department is to insure compliance to billing regulations yet also insure a payment.
POSITION
Summary:
The Resource Planning Analyst is responsible for a wide variety of functions.
Daily functions revolve around analyzing and resolving issues with accounts that involve authorization, utilization review, billing, and compliance.
This position is responsible for independently monitoring and ensuring that utilization review has been completed on all hospitalizations.
Serves as an expert in understanding the payers' requirements and works with various other departments to identify issues and resolve them.
Responsible for independently providing a higher-level review of denials to determine a root cause.
Analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials.
This position uses expert knowledge of payer requirements to write appeals for administrative authorization denials.
Identifies and develops appropriate tools to track issues, analyzes workflows, identifies logistical and operational issues to target for improvement.
Responsible for reviewing accounts with various claim errors that require higher-level review.
This can include claims with admission or discharge date discrepancies, admission order timing issues, or various other regulatory compliance issues.
Responsible for interdepartmental/intradepartmental communication and process improvement throughout the revenue cycle.
Must become competent in all available systems where revenue cycle information is held.
Organizational Expectations Practices within the Medical Center's policies and procedures.
Adheres to the Intensive Caring Value statements as demonstrated through positive patient/guest relations, positive and effective interactions with staff and formulating and meeting developmental goals.
Minimum Qualifications Qualified candidates should have a bachelor degree in healthcare administration or appropriate closely related field.
Knowledge of all aspects of the revenue cycle is considered extremely helpful:
(scheduling, patient flow through the system for inpatient and outpatient, patient placement, charge entry, billing).
Operational knowledge of the primary revenue cycle systems (EPIC) along with systems processes and design preferred.
Experience with Excel, Access, OneNote, and PowerPoint is required.
Ability to synthesize information and concisely communicate either verbally or in writing is essential.
Ability to work well under pressure.
Ability to demonstrate independence, self-initiative, thoroughness, and attention to detail.
Job Description Functions as integral member of the health care team to reflect the culture of cooperation, enthusiasm and respect.
Implement strategies to enhance the strategic plan of the Medical Center to improve access and services to our customers and to ensure reimbursement of hospital services.
Responsible for monitoring and insuring the accuracy of registration errors through a series of reports, correcting errors, collecting and coordinating QA and developing reporting mechanisms for various groups.
Insure that errors are corrected in a timely manner prior to bill drop.
Solve problems related to the various issues identified through this process and consistently progress toward improving the reasons why things happen.
Position located at University Hospitals.
Minimum Education Required:
Bachelor's Level Degree or equivalent combination of education and experience.
Required
Qualifications:
Bachelors degree in appropriate field or equivalent combination of education and exp.
Regular 40 First Shift.
Estimated Salary: $20 to $28 per hour based on qualifications.
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