Pre-Legal / Denials Prevention Coordinator -HB Patient Financial Services-FT-Day

UCI Health; Anaheim (CA); Sur place; USD 70 000 - 90 000; Plein temps

Avantages offerts par ce poste

Medical insurance

Retirement plans

Other benefits

Résumé du poste

A prominent healthcare organization in Anaheim is seeking a Reimbursement HC Analyst to act as a liaison between Patient Financial Services and legal partners. The role requires extensive knowledge of hospital billing processes and claims resolution. Candidates must have at least 5 years of relevant experience and strong communication skills. This full-time position offers comprehensive compensation, including medical insurance and retirement plans.

Qualifications

• Minimum 5 years’ experience in acute hospital billing and collections.
• Good math skills and excellent communication in English.
• Advanced knowledge of CPT, HCPCS and ICD billing codes.
• Ability to troubleshoot and resolve routine and non-routine errors.
• Ability to establish effective working relationships across the Health System.

Responsabilités

• Serve as a liaison between Patient Financial Services and legal partners.
• Investigate, manage, and resolve claims and disputes.
• Apply advanced contract knowledge as a denial specialist.
• Identify payer and organizational trends and assist in resolving issues.

Connaissances

Computerized systems and applications

Acute hospital billing and collections

Written and verbal communication

Data and numerical data entry

Revenue cycle processes

Critical thinking and problem solving

Interpersonal skills

Formation

Bachelor’s Degree in Business, Finance, or related field

Outils

CPT/HCPCS/ICD billing codes

Computerized systems

Description du poste

Overview

Join to apply for the Reimbursement HC Analyst 3-HB Patient Financial Services-FT-Day role at UCI Health.

Position Summary: Serves as liaison between Patient Financial Services UC Irvine Health and legal business partners in the investigation, management, resolution and defense of claims, appeals, arbitrations or any other form of disputes up to and including legal proceedings. The duties vary including support of matters in pre-litigation and active litigation. Other legal work involves management of subpoenas, court appearances, mediations and trial appearances. This incumbent exhibits advanced knowledge of contract terms and conditions, serves as denial specialist and acts as a resource to other staff dealing with difficult accounts requiring troubleshooting assistance. Responsible for identifying trends by the payers and UCI, assisting in the resolution as appropriate.

Responsibilities

• Work as a liaison between Patient Financial Services and legal business partners.
• Investigate, manage, and support resolution of claims, appeals, arbitrations, subpoenas, court appearances, mediations and trial appearances.
• Apply advanced knowledge of contract terms and conditions; act as denial specialist and troubleshoot difficult accounts.
• Identify payer and organizational trends and assist in resolving issues as appropriate.

Required Qualifications

• Skilled at using computerized systems and applications to maintain/update patient accounting information.
• Minimum 5 years’ experience in acute hospital billing and collections, contract interpretation and claim denial resolution.
• Good math skills; excellent written and verbal communication in English.
• Effective data and numerical data entry skills; experience with CPT, HCPCS and ICD billing codes, authorization requirements and related documentation.
• Advanced knowledge of revenue cycle processes in a healthcare setting; experience with a variety of payers (governmental and non-governmental).
• Ability to think critically, problem solve independently and/or collaboratively; resolve routine and non-routine errors; maintain appropriate work pace.
• Ability to establish and maintain effective working relationships across the Health System.

Preferred Qualifications

• Prior reimbursement analyst experience.
• Legal or paralegal training (CPHRM).
• Bachelor’s Degree in Business, Finance, or related field, or equivalent combination of education and experience.

Conditions of Employment

The University of California, Irvine (UCI) seeks to provide a safe and healthy environment for the entire UCI community. All applicants who accept an offer of employment must comply with the following conditions of employment: Background Check and Live Scan; Employment Misconduct; Legal Right to Work in the United States; Vaccination Policies; Smoking and Tobacco Policy; Drug Free Environment.

Misconduct Disclosure: The final candidate who accepts a conditional offer will be required to disclose any misconduct findings within the last seven years; pending investigations; or any related proceedings.

Additional policy references may apply by business unit. UCI is an Equal Opportunity Employer and provides reasonable accommodations for applicants with disabilities upon request. For more information, contact the Employee Experience Center at [e-mail] or [phone], Monday - Friday from 8:30 a.m. - 5:00 p.m.

Compensation and Employment Type

Employment type: Full-time. Total compensation and benefits information is provided by the employer and may include medical insurance, retirement plans, and other perks. Location mentioned: Los Angeles, CA (note: context from page may include multiple postings).

Seniority level

Mid-Senior level