HEALTHCARE ACCESS QUALITY ANALYST

Cooper University Health Care; Camden (NJ); On-site; USD 47,000 - 77,000; Part time

Job summary

Cooper University Health Care in Camden, NJ seeks a Healthcare Access Quality Analyst to oversee the HCA registration compliance integrity system, analyze denials, and support improvement initiatives across the revenue cycle.

This per diem, day-shift role partners with Epic and other teams to optimize registration processes, monitor Medicare/ payer requirements, and provide data-driven insights to leadership.

Qualifications

• Minimum four years' experience preferred in hospital, ambulatory, patient access, or related revenue cycle experience.
• Demonstrated ability to research, collect, and present information.
• Strong computer skills; proficiency with Microsoft Office suite. Thorough understanding of ICD-10, CPT codes, HCPCS codes. Epic User Web / Optimization skills required.
• Excellent interpersonal skills as well as superior writing skills. Deadline oriented; ability to work independently and in a team environment. Ability to manage multiple complex and concurrent projects.

Responsibilities

• Reviews and analyzes denial data for all denials occurring within the scope of HCA to determine denial trends and helps develop remediation plans and/or workflow resolutions.
• Presents denial metric driven information and workflow opportunities to Healthcare Access Leadership
• Reviews and analyzes Notice of Admission submission to ensure we are submitting within payer driven requirements.
• Analyze IP Only CPT codes for scheduled procedures to help identify best practice to identify and ensure proper authorization is obtained for the CPT code and site of service.
• Develop and maintain Executive Summary for Medicare Compliance Reports and collaborate with leadership on trends and opportunities for compliance within the IMM, MOON, and MSPQ collection process.
• Collaborate with Epic IT to ensure optimization of Epic Registration Dashboards for quality and productivity.
• Collaborate with Revenue Cycle University to develop annual CLN's and quality assurance processes for all HCA Team Members. Develops and monitor EPIC reports and work queues to ensure timely response to denied cases and appeals and provides follow-up on cases until resolution has been achieved.
• Evaluate trends found in Epic DNB, Claim Edit, and Patient work queues and help develop remediation plans for leaders to deliver to front end users.
• Assist in the on-going support of data collection, analyzation, and developing/implementing new strategies to ensure an effective registration process.
• Participate in development of documents to drive quality improvement, including the design of quality monitoring forms and quality standards. Document and update policy, process, procedures, guidelines, and training materials.
• Develops and maintains positive, collaborative, supportive working relationships with all members of the organization.
• Serve as a Subject Matter Expert on all areas within the scope of HCA. Provides support to all HCA in Camden and Cape May. All other duties as assigned by HCA Leadership

Job description

HEALTHCARE ACCESS QUALITY ANALYST

Camden, NJ

Job ID 72939

Job Type Per Diem

Shift Day

Specialty Other Professional

About us

At Cooper University Health Care, the commitment to providing extraordinary health care begins with our team. Our extraordinary professionals are continuously discovering clinical innovations and enhanced access to the most up-to-date facilities, equipment, technologies and research protocols. We have a commitment to our employees to provide competitive rates and compensation programs. Cooper offers full and part-time employees a comprehensive benefits program, including health, dental, vision, life, disability, and retirement. We also provide attractive working conditions and opportunities for career growth through professional development.

Discover why Cooper University Health Care is the employer of choice in South Jersey.

Short Description

Manages comprehensive HCA registration compliance integrity system and works toward goals and objectives for optimizing departmental performance and denial mitigation. Has a sound understanding of the payor policies related to denials and appeals process for denials deemed within Healthcare Access scope.

• Reviews and analyzes denial data for all denials occurring within the scope of HCA to determine denial trends and helps develop remediation plans and/or workflow resolutions.
• Presents denial metric driven information and workflow opportunities to Healthcare Access Leadership
• Reviews and analyzes Notice of Admission submission to ensure we are submitting within payer driven requirements.
• Analyze IP Only CPT codes for scheduled procedures to help identify best practice to identify and ensure proper authorization is obtained for the CPT code and site of service.
• Develop and maintain Executive Summary for Medicare Compliance Reports and collaborate with leadership on trends and opportunities for compliance within the IMM, MOON, and MSPQ collection process.
• Collaborate with Epic IT to ensure optimization of Epic Registration Dashboards for quality and productivity.
• Collaborate with Revenue Cycle University to develop annual CLN's and quality assurance processes for all HCA Team Members. Develops and monitor EPIC reports and work queues to ensure timely response to denied cases and appeals and provides follow-up on cases until resolution has been achieved.
• Evaluate trends found in Epic DNB, Claim Edit, and Patient work queues and help develop remediation plans for leaders to deliver to front end users.
• Assist in the on-going support of data collection, analyzation, and developing/implementing new strategies to ensure an effective registration process.
• Participate in development of documents to drive quality improvement, including the design of quality monitoring forms and quality standards. Document and update policy, process, procedures, guidelines, and training materials.
• Develops and maintains positive, collaborative, supportive working relationships with all members of the organization.
• Serve as a Subject Matter Expert on all areas within the scope of HCA. Provides support to all HCA in Camden and Cape May. All other duties as assigned by HCA Leadership

Experience Required

• Minimum four years' experience preferred in hospital, ambulatory, patient access, or related revenue cycle experience.
• Demonstrated ability to research, collect, and present information.
• Strong computer skills; proficiency with Microsoft Office suite. Thorough understanding of ICD-10, CPT codes, HCPCS codes. Epic User Web / Optimization skills required.
• Excellent interpersonal skills as well as superior writing skills. Deadline oriented; ability to work independently and in a team environment. Ability to manage multiple complex and concurrent projects.

Education Requirements

Bachelor's Degree preferred.

License/Certification Requirements

HFMA certification or equivalent certification in NAHAM, AAHAM preferred.

Special Requirements

• Healthcare experience preferred.
• Knowledge of Payor Portals & Policies
• Knowledge of EPIC account, patient, and referral wqs

Hourly Rate Min $34

Hourly Rate Max $56

The New Jersey Pay Transparency Act requires disclosure of the pay range for this position.

A salary offer will vary based on the job role, candidate experience, qualifications, internal pay equity and market data.

Cooper University Health Care is an Equal Opportunity Employer and is committed to equal employment opportunity for all team members. All employment decisions are based on business needs, job requirements and individual qualifications, without regard to race, color, religion or belief, or any other status protected by law or regulation. To request reasonable accommodation, contact [e-mail]