#123000 Revenue Cycle Business Analyst - Hybrid/Remote

DESCRIPTION

UC San Diego Health's Revenue Cycle department supports the organization's mission to deliver outstanding patient care and to create a healthier world - one life at a time. We are a diverse, patient-focused, high-performing team with a commitment to quality, collaboration, and continuous improvement that enables us to deliver the maximum standard of care to our patients. We offer challenging career opportunities in a fast-paced and innovative environment and we embrace individuals who demonstrate a deep passion for problem-solving and customer service.

Reporting to the Manager of Business Analytics, the Revenue Cycle Business Analyst will play a key role in supporting the efforts of senior leadership by providing sound insight and guidance from a financial data and reporting perspective. Encompassing both Professional and Hospital Billing, the successful candidate will exist in a hybrid role functioning as a revenue cycle subject matter expert and serve as a key liaison between clinical administration and the different functional areas of the revenue cycle operation.

Core competencies for this senior level role will include but not limited to the following:

REPORTING:

The ability to provide first rate analytical support with advanced proficiency in SQL, BI Tools, excel skills, and flow charting software. Hands-on experience in statistical analysis, data-mining, quantitative financial research required; develop effective statistical models for segmentation, classification, and optimization. A sound understanding of relational databases and ability to scope and self-service extracts based on common fields and table joins via primary & secondary keys. Strong modeling and presentation skills, experience and comfort with statistical modeling packages, and comfort with large data sets.

REVENUE CYCLE MANAGEMENT:

As a member of the Continuous Improvement team, the Business Analyst will have oversight of revenue cycle performance metrics and be responsible for the development and delivery of effective reporting and complex analytical solutions in support of these measures. Experience must include all functions within scope of the revenue cycle operation; patient access, charge capture, coding, patient billing, collections and customer service.

Demonstrates a proven ability to independently interpret challenges faced by management and correlate into the development of meaningful analyses that can be used to assess operational performance. Apply problem analysis and resolution principles; establish situation response guidelines and take appropriate actions toward resolving revenue cycle concerns/issues with minimal direction. Develop and manage new KPI's and supplemental views to assess charge, payment and adjustment activities, provider productivity and associate care payment transfers, payor adjudication windows, denials inventory, Bad Debt and AR.

The incumbent will serve in a consultative role of workflow assessment and identify process inefficiencies by reporting on trends in reimbursement and denials. Will then correlate trend interpretations with an action plan toward resolution for approval from Revenue Cycle Leadership. Drive business process improvement by indicating recommendations to existing workflows and report development wherever possible; continuously identify processes to automate/eliminate waste, duplicated effort. Proven knowledge of government and non-government payor requirements, industry reimbursement rules, laws and regulations that govern billing/collection activities. Demonstrated knowledge of medical terminology, CPT, ICD-10, HCPCS, modifier codes and including impact on reimbursement, coverage etc.

BUSINESS ANALYSIS:

The ability to develop key relationships with clinical administration and physician leadership in an effort to support their interpretation and understanding of revenue cycle operations and reporting. Responsible for driving month end performance review summary and developing clear lines of communication through strong presentation of supplemental findings to internal stakeholders and divisional administration. In support of revenue cycle leadership, provide critical information and insight needed to make fact-based decisions and foster strong business relationships providing key internal customers with sound data analyses.

CONTRACTING:

Oversight of contract build, development and maintenance functions in EPIC and related financial modeling tied to reimbursement analytics. Paramount to UCSD’s successful adaptation to changes in the payor policy, the resource will be responsible for leveraging remittance, claim and denial detail to provide leadership with sound interpretations of whether payors are interacting in alignment with established contractual language. Additionally, support initiatives tied to systemic build efficiencies, account prioritization (ROI), and underpayment opportunities etc.

MINIMUM QUALIFICATIONS

• Bachelor's Degree in business, healthcare administration or related area; and/or equivalent experience/training.

• A minimum of five (5+) or more years of relevant experience.

• Experience and proven success in the practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.

PREFERRED QUALIFICATIONS

• EPIC (or comparable EMR) super user competencies.

• Ability to manage ad-hoc reporting initiatives on behalf of operational resources and triage revenue cycle issues toward resolution.

• Exposure to contracting module and ability to manage interpretation and build functions.

• Transaction based revenue cycle financial literacy, ability to comprehend complex concepts and identify actionable opportunities through reporting and analytical models etc.

SPECIAL CONDITIONS

• Must be able to work various hours and locations based on business needs.

• Employment is subject to a criminal background check and pre-employment physical.

Job offer is contingent on successful engagement in the UC COVID-19 Vaccination program (fully vaccinated with documented proof or approved exception/deferral).

If applicable, life-support certifications (BLS, NRP, ACLS, etc.) must include hands-on practice and in-person skills assessment; online-only certification is not acceptable.

UC San Diego Health is the only academic health system in the San Diego region, providing leading-edge care in patient care, biomedical research, education, and community service. Our facilities include two university hospitals, a National Cancer Institute-designated Comprehensive Cancer Center, Shiley Eye Institute, Sulpizio Cardiovascular Center, the only Burn Center in the county, and and dozens of outpatient clinics. We invite you to join our team!

Applications/Resumes are accepted for current job openings only. For full consideration on any job, applications must be received prior to the initial closing date. If a job has an extended deadline, applications/resumes will be considered during the extension period; however, a job may be filled before the extended date is reached.

To foster the best possible working and learning environment, UC San Diego strives to cultivate a rich and diverse environment, inclusive and supportive of all students, faculty, staff and visitors. For more information, please visit UC San Diego Principles of Community.

UC San Diego Health is an Equal Opportunity/Affirmative Action Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, disability, age, protected veteran status, gender identity or sexual orientation. For the complete University of California nondiscrimination and affirmative action policy see: http://www-hr.ucsd.edu/saa/nondiscr.html

UC San Diego is a smoke and tobacco free environment. Please visit smokefree.ucsd.edu for more information.

UC San Diego Health maintains a marijuana and drug free environment. Employees may be subject to drug screening.