Decision Support Specialist jobs in Pasadena, TX

JOB SUMMARY

The position is responsible for the development, management and maintenance of charge master, various labor productivity and expense benchmarking tools, the development and reporting of financial and statistical data to management, supporting revenue cycle processes such as denial management, and changes and participates in the development of the annual budget. This position will interact with all levels of the organization to ensure a quality understanding of the financial reporting process and how to use related data to impact operational performance. In addition, this position will complete special projects and cost/benefit analysis to assist in business planning. The Decision Support Analyst may be responsible for preparing reports, analyzing data, and presenting analysis findings to department leadership. The analyst must have demonstrated working knowledge and a high-level understanding of data reporting and of revenue cycle operations.

JOB DUTIES AND RESPONSIBILITIES

Job Specific:

• Understands the flow of information within the hospital and professional billing system and how to match fields and data to revenue cycle processes. Meets with information services partners to understand system and process impacts on revenue cycle workflow. Produces narratives mapping processes to data.
• Responsible for maintaining HFMA Key Performance Indicators (Pre-Registration Rate, Insurance Verification Rate, Conversion Rate Uninsured to Insured, Point of Service Collections, DNFB, FBNS, DNSP, Clean Claim Rate, Late Charge Percentage, AR Days, Aged AR as a Percent of Total Billed AR, Denial Rate, Bad Debt, Denial Rate as % of Net Patient Revenue, Charity Care, Credit Balance, Uninsured Discount, Uncompensated Care, Case Mix Index, Cost to Collect, Percent of Patient Scheduled, Aged AR by Payer Source). (EF)
• Demonstrates initiative and follow through by participating in performance improvement efforts. (EF)
• Assists with the preparation of the annual operating and capital budgets for the medical center, establishing and maintaining strong working relationships with department leaders. Defines the timeline, logistics and methodology appropriate for the process and work with Senior Leadership and department managers to compile the budget from 1st draft through final presentation. Ensures the budget is downloaded accurately and reports are distributed to department leaders on a timely basis. (EF)
• Participates in the strategic planning process at the department and/or organizational level and support strategic plans by aligning departmental goals and activities with the organization's strategic direction. Ensures that goals and direction are communicated to staff and peers and that budget processes align and support the goals of the organization. (EF)
• Assists Accounting Manager with maintaining accurate timely data in the financial reporting system and provide meaningful reports to the medical center's management on a regular or ad hoc basis, as appropriate, to help facilitate the decision-making process. (EF)
• Maintains and prepares statistical data for the medical center and provide timely and accurate reporting of statistics to the Accounting Department, department leaders and the executive team for use in external and internal reports. (EF)
• Evaluates requests for data analysis support and assists revenue cycle leaders and staff in defining project scope. Demonstrates intellectual curiosity to define problems and develop analyses to support solution development. Documents understanding of background need and driving factors and provides thorough assessment of overall project impact to revenue cycle operations. Quantifies impact using key performance indicators, where appropriate.
• Provides support specific to denial reporting and root cause analysis. Actively participates in developing and defining key data feeds to drive denial mitigation efforts across the organization.
• Ad-Hoc reporting and analysis, as needed, at the direction of the Chief Financial Officer. Interprets data and summarizes findings and presents to revenue cycle/ finance department leadership. Makes recommendations for process improvement or escalates to the Manager for additional investigation and action plan development.
• Adds value to decision-making process. Works with the Chief Financial Officer and department leaders as requested to assist in analyzing business decisions and provide the financial perspective, statistical data, cost/benefit analysis, reimbursement information, etc.
• Distributes the monthly procedure analysis report and provides department directors assistance in analyzing data. (EF)
• Manages and maintains the charge master including new charge item set up, price & description changes, deletions and maintain accurate procedure coding and charges. Ensures that annual price updates are made on a timely basis. (EF)
• Works with department leaders of revenue producing departments to monitor and implement ongoing changes in Medicare's outpatient prospective payment system and the related coding of outpatient procedures and services. Ensures the Hospital maintains compliance with regulations and captures accurate reimbursement for services provided. (EF)
• Acts as liaison with Information Technology and/or outside vendors to support relevant systems.

Hospital:

• Adhere to organization-wide and other applicable policies and procedures.
• Day-to-day performance complies with the hospital’s Service Excellence Behavioral Expectations.
• Perform within the prescribed limits of the hospital’s Ethics, Compliance and Confidentiality Program guidelines.
• Perform within his/her professional Scope of Practice at all times.

Other Duties As Assigned:

• Nothing in this job description restricts management’s right to assign or reassign duties and responsibilities to this job at any time.