Note: The job is a remote job and is open to candidates in USA. Shepherd Center, a leading rehabilitation hospital, is seeking a Data Quality Analyst to manage data quality projects within the Revenue Cycle. The role involves analyzing credit balances, managing project timelines, and providing insights to enhance financial services operations.
Responsibilities
- Completes all projects accurately and within allotted timeframe
- Clarifies details of all projects to ensure an understanding of desired outcome of project
- Maintains a calendar of deadlines for all projects
- Notifies PFS supervisor of any delays or roadblocks encountered with projects
- Assists as needed in collecting and communicating orders for Piedmont surgeries to Piedmont staff and assists with reconciling and balancing all Piedmont surgery and ancillary charges in an accurate and timely manner, maintaining appropriate spreadsheets
- Posts charge corrections accurately and in a timely manner
- Accurately documents account history with details of any action taken
- Notes variances in a timely and accurate manner
- Serves as a resource to PFS Supervisor to assist as backup for vacancies, PDO and backlogs in all PFS areas
- Performs account audit based on agreed upon parameters
- Assists with special projects as needed
- Assists with system testing and training under direction of the PFS Manager
- Completes review of all insurance and self-pay credit balances accurately and within a timely manner
- Requests appropriate refunds based on SC guidelines accurately and in a timely manner
- Provides supporting documentation for all requests exceeding specified limits
- Notifies PFS management of all identified trends in received Refund Requests within a timely manner
- Notifies PFS management of any high dollar Refund Request within a timely manner
- Develops/runs appropriate queries to target data to be reviewed
- Assists as needed to complete HCIA Quarterly Inpatient survey in a timely manner
- Assists with maintenance of Daily spreadsheets (Key Indicators & Daily AR Balancing) in a timely and accurate manner
- Provides tracking and reporting all charge entry errors to the PFS Supervisor
- Provide data and support to management from on-going projects and in identification of any issues, including inhouse, discharged but unbilled, insurance, and authorization delays
- Provide accurate compliance reporting data, reporting through system queries as needed
- Identifies and reports all repeat discrepancies found as part of routine duties
- Keeps abreast of all PFS billing, follow up and refund processes and procedures to ensure all processes are compliant per federal guidelines
- Maintains knowledge of all industry changes and incorporates those into process after PFS supervisor approval
- Keeps abreast of and is able to interpret all Shepherd Center contracts accurately. Aware of resources available for assistance as needed
Skills
- College degree preferred or equivalent work experience
- Previous Patient Financial Services experience knowledge in multiple areas, including refund, credit balance, authorization and denials related reporting
- 5 - 7 years' Patient Financial Services experience in multiple PFS practices
- Experience working with medical payers including Medicare, Medicaid, and commercial insurance, Workers Compensation
- Working knowledge of financial systems
- Excellent organizational skills
- Proficiency in Microsoft Office Suite
- Knowledge of all aspects of Revenue Cycle practices required
- Must be proficient in Excel and A/R software
- Strong keyboard skills
- Organizational skills to manage multiple ongoing projects
- Works well in environment and self-discipline with firm deadlines; results oriented
- Perform multiple tasks effectively
- Able to work both independently and as part of a team
- Strong analytical skills required
- Capable of making timely, independent decisions
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