Patient Access Quality Assurance Analyst

Job Requisition: REQ2785

Employment Type: Full-Time

Shift: Days

Hours Per Week: 40 Hours

Hiring Range : $ 21.44 - $29.56

The actual compensation for this position will be determined based on experience and other factors permitted by law.

Responsibilities:

• Review denial trends and identifies, develops and implements new processes to prevent future denials and write offs.
• Compiles and summarizes data and presents results to Patient Access and clinics leadership and other departments as needed
• Complete daily eligibility related worklists for both Acute and Ambulatory, and corrects information in the EMR
• Provide educational feedback to employees and supervisors/managers
• Determine root cause of denials, analyze data and trends related to both financial and operational data and key performance indicators
• Assist with training employees of Patient Access by collaborating with the Educator of Revenue Cycle and help develop remedial training.
• Act as a liaison between the eligibility vendor and St Mary and collaborate with the vendor to ensure optimal utilization and best workflows
• Collaborate with department leadership and educator to create and maintain relevant SOPs related to eligibility and prior-auth requirements, registration fundamentals and scheduling.
• Works with Patient Access leadership to develop new key performance indicators and monitor existing KPIs to ensure qualitative and quantitative metrics are achieved
• Evaluates actual versus planned performance and metrics, presents and communicates possible opportunities. Identifies and suggests resolution for problems involving departments which affect registration productivity and or data quality and compliance
• Performs reviews of all Access data elements, such as real time eligibility (RTE), Medicare Payer Secondary Questionnaire (MSPQ), Insurance plan codes, proper sequencing of COB (Coordination of Benefits), and reviews physician licensure
• Assist as needed in other functions within Patient Access

Education:

Associates degree in Business, Accounting or Healthcare related field required. Minimum of (two) 2 years of experience in a healthcare setting with administrative, financial or denial management work. Demonstrated knowledge of advanced excel and analytical skills

Certifications / Licensure CHAA preferred or obtain within 1 year of employment

Required Skills/Attributes:

Ability to organize and establish day-to-day priorities while using critical thinking skills in all aspects of

the job.

• Must be able to multitask while remaining professional, focused, composed and positive.

• Excellent customer service skills

• Displays integrity, friendliness, and compassion.

• Must be able to establish an appropriate and effective rapport with others.

• Demonstrates flexibility

• Takes initiative

• Able to work in a fast-paced environment

• Embraces new opportunities to grow both personally and professionally.

• Effective critical thinking and problem-solving skills.

• Proficient with various Microsoft Office products (Word and Excel).

• Strong organizational skills.

• Effective interpersonal skills.

• Ability to take and follow direction in a positive and appropriate manner.

• Ability to work as part of a team and independently. Must be able to demonstrate effective and

appropriate written and oral communication skills.

• Must be able to speak, read, write and follow instructions in English.