Sr Revenue Cycle Denials Prevention Partner

Job DescriptionLocation: Chicago, ILHospital: RUSH University Medical CenterDepartment: Patient Financial ServicesWork Type: Full Time (Total FTE between 0.9 and 1.0)Shift: Shift 1Work Schedule: 8 Hr (8:00:00 AM - 4:30:00 PM)Summary:The Denials Prevention and Improvement Consultant is responsible for oversight of Revenue Cycle denials prevention solutions. This role is responsible for providing detailed analytics, researching, and distributing denials information, as well as identifying trends or patterns with payors. This position will also be responsible for coordination, analysis, tracking, and reporting of all denials, write-offs, and recoveries for all lines of business. This role will support execution of strategic initiatives, process re-design, root cause analysis, metric milestone/report development and special projects as it related to denials prevention. This role will also support developing and delivering education to various process participants as part of continuous process improvement. The individual who holds this position will be required to exemplify the Rush mission, vision and values and acts in accordance with Rush policies and proceduresResponsibilities: Serve as accountability owner for denials prevention outcomes; address shortfalls and opportunities when established metrics and goals are not achieved. Support strategic planning initiatives and participates in effective execution of planning relevant to functional area(s). Proactively work with multidisciplinary teams within the organization to develop procedures to reduce denials through development of best practices. Collaborate with Patient Access, Charge Integrity, CDI & UR, Patient Financial Services, and clinical departments to identify root causes and track action plans. Leverage technology to streamline and automate where possible and ensures that automated solutions and applications (Epic and non-Epic) support functional objectives to ensure denials prevention and performance improvement. Develop working relationship with department leads to support denials prevention operational needs. Schedule and facilitate monthly denials taskforce meetings with Financial Clearance, Clinical Based Denials, Middle Revenue Cycle, and Patient Financial Services leaders. Support material development and facilitation of monthly denials prevention report out to Revenue Cycle leadership. Compile, analyze, and report on data related to denials, write-offs, recoveries, and revenue opportunities on a regular basis. Categorize denials based on root cause finding and distributes reports and metrics to applicable management and teams. Compile and distribute denials and adjustment trending summaries to all stakeholders Stays abreast of industry & regulatory changes impacting functional area and Revenue Cycle and identifies potential impact and required changes. Strives to promote best practices within functional area and within revenue cycle. Continuously review applicable regulations, payer updates, and other applicable industry changes Provide education and feedback to providers, departments, and clinics in relation to denials that impact revenue flow and or charge capture Ensures protection of private health and personal information, including credit card information. Adheres to all federal and state compliance regulations. Exhibits knowledge of HIPPA awareness and compliance with emphasis on respect of the patients’ rights to privacy, dignity, and confidentiality Other duties as requested and assignedOther information:Required Job Qualifications: Bachelor’s degree in business, finance or related discipline required; equivalent work experience may be considered in lieu of degree. At least five years of experience required in billing, collections, insurance, technology support, or customer service. Must have strong knowledge of revenue cycle business operations. Excellent verbal and written communication skills due to direct interaction with senior management. Strong time management and organizational skills with the ability to effectively multi-task and meet deadlines. Strong problem solving and financial analytical skills. High degree of accuracy for analyses and processes. Self-motivated. Must have a strong customer service focus. Ability to plan, coordinate and implement projects. Ability to interact professionally with all levels of employees Ability to work amongst diverse teams. Aptitude for improving professional knowledge and technical skills through development efforts. Must have a high level of integrity. Ability to observe payment trends, determine root cause of errors, identify possible solutions and suggest changes to workflows as needed. Ability to provide colleagues with necessary documentation and pertinent summaries regarding denials prevention performance, including denial rates, trending, write-offs, and recoveries.Preferred Job Qualifications: Professional certification (CPA, HFMA, Epic system or similar) preferred At least one year of leadership experience in a multi-facility, integrated health care delivery system or consulting experience Solid understanding of CPT/HCPCS/Revenue/ICD-10 coding. Significant knowledge of Medicare, Medicaid, and third-party payer billing, rules, guidelines, compliance, and regulations. Proficient in Microsoft office (Word, PowerPoint, Excel) Familiarity with advanced data management software (Tableau, QuickSight, PowerBI)Disclaimer: The above is intended to describe the general content of and requirements for the performance of this job. It is not to be construed as an exhaustive statement of duties, responsibilities or requirements.Rush is an equal opportunity employer. We evaluate qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, veteran status, and other legally protected characteristics.Position Sr Revenue Cycle Denials Prevention PartnerLocation US:IL:ChicagoReq ID 9250