Hospital AR and Denial Management Analyst

Facility

Cape Fear Valley Medical Center

Location

Fayetteville, North Carolina

Department

Patient Financial Services Operations

Job Family

Professional

Work Shift

Days (United States of America)

Summary

Assist the Physician Revenue Cycle, CFV Medical Group and Provider Enrollment teams by reducing delays impacting Professional AR within CFV.

Major Job Functions

The following is a summary of the major essential functions of this job.  The incumbent may perform other duties, both major and minor, that are not mentioned below.  In addition, specific functions may change from time to time:

• Work with Physician Revenue Cycle on AR issues related to payer enrollment discrepancies and credentialing

• Create Strategic Plan for AR resolution as it relates to credentialing and payer enrollment to help minimize impact on cash and create workflows to improve payer enrollment process

• Manage and oversee the release of providers and holding of providers in Epic to ensure timely resolution and denial reduction

• Identify areas for improvement while mitigating payment disruption

• Trend and provide denial analysis and share results to foster improvement and denial reduction

• Assist Director/PB Revenue Cycle, Managed Care leaders and Provider Enrollment manager on expanding delegated arrangements to expedite enrollment process and reduce delays and lag in enrollment process

• Align Individual Group Tax ID to corporate strategic structure and help establish controls to ensure that structure and integrity is maintained

• Other duties as assigned

Minimum Qualifications

The following qualifications, or equivalents, are the minimum requirements necessary to perform the essential functions of this job:

Education and Formal Training: 

• Bachelor’s degree required OR in lieu of degree 10 years collective experience in Physician Accounts Receivable, Provider Enrollment, Provider Onboarding, Managed Care Contracting and Medical Staff Services as well as payer-related duties relating to credentialing and enrollment required

Work Experience: 

• 5 years' experience required

Knowledge, Skills, and Abilities Required: 

• Proficiency in reading, writing, and speaking the English language

• Excellent interpersonal skills with the ability to interact with internal hospital department leadership as well as outside organizations

• Strong written and verbal skills, results oriented, and exemplify a team player attitude

• Expert skills in Microsoft Word, Excel, PowerPoint and Access or other software as required

• Willing and able to work on a variety of activities and projects

• Ability to work with people in a tactful, diplomatic manner

Physical Requirements: 

• Present a professional image

Required Licenses and Certifications

Cape Fear Valley Health System is an Equal Opportunity Employer M/F/Disability/Veteran/Sexual Orientation/Gender Identity