Transplant Revenue Analyst

St. David's HealthCare; Austin (TX); On-site; USD 65,000 - 90,000; Full time

Benefits offered by this job

401(k) Plan with company match

Tuition assistance

Employee stock purchase plan

Comprehensive benefits

Job summary

St. David's South Austin Medical Center is seeking a Transplant Revenue Analyst to review pre-evaluation and global service agreements, analyze provider payments, and manage revenue for transplant contracts.

The role requires knowledge of hospital revenue cycle processes and insurance payor relations. The analyst will monitor claims, denials, and accruals, ensuring accurate reimbursement across Medicare/Medical contracts and PSA arrangements, while supporting month-end reporting and financial

Qualifications

• Bachelor’s degree or 4 years’ equivalent experience.
• Minimum of 2 years of direct experience in hospital revenue cycle and/or transplant operations.

Responsibilities

• Review pre-evaluation and global service agreements and analyze provider payments.
• Oversee and audit payors and provider payments and revenue for transplant accounts.
• Maintain accurate records of claims, denials, and accruals; monitor revenue cycle discrepancies.
• Collaborate with providers and insurance relations to resolve billing/claims issues.

Skills

Excel

Data analysis

Communication

Customer service

Auditing

Education

Bachelor’s degree or 4 years’ equivalent experience

Tools

UB04 processing

HCFA/HCPCS knowledge

Job description

Do you have the career opportunities as a Transplant Revenue Analyst you want with your current employer? We have an exciting opportunity for you to join St. David's South Austin Medical Center which is part of the nation's leading provider of healthcare services, HCA Healthcare.

Job Summary And Qualifications

This position is responsible for the review of pre-evaluation and global service agreements. He/she will be responsible for analyzing provider payments, handling provider inquiries and maintaining good customer relations. The Revenue Analyst is responsible for the oversight analysis of insurance contract payments and disbursements for both insurance and PSA contracts. Additionally, the Transplant Contract and Revenue Analyst will be responsible for overseeing and auditing payors and provider payments and revenue for transplant account reimbursement and Medicare cost report activities. Accountable for understanding and keeping current with transplant payor contracts and provider agreements. Responsible for Reconciling BMT, CAR‑T, and other large dollar Rx accounts against revenue codes to ensure the more significant charges are captured before claims are released for the final bill.

Must be able to understand general ledger for proper expense of accounts payable to help with month-end reporting.

• Processes UB04, HCFA and submitted expenses for provider claim adjudication. Knowledge of hospitals and professional billing standards. Ensure incoming claims are documented and filed daily for timely processing. Submits claims to the appropriate insurance company based on the process outlined in each transplant contract.
• Familiar with MCR payment guidelines which include CPT, HCPCs for diagnostic testing, surgery and labs. Responsible for investigating procedure codes for claims payment.
• Must enter and identify all claims in the global billing database as either a physician or a facility claims under the appropriate phase of transplant. Identify if claims are included or excluded in case rate to calculate appropriate reimbursement of claims.
• Research vendor contracts and addresses inquiries regarding possible errors with processed claims.
• Keeps accurate records of claims denials, processed claims, and accruals for accounting. Knowledge of excel and proficient with formulas and data entry.
• Proficient in understanding the phases associated with Global Reimbursement and Global Contracts. Ensures Global provider claims are processed according to contract. Must enter and identify all claims in the global billing database as either a physician or a facility claims under the appropriate phase of transplant. Identify if claims are included or excluded in case rate to calculate appropriate reimbursement of claims.
• Works collaboratively with providers, insurance provider relations representative and the revenue cycle center to resolve any billing/claims related issues.
• Ability to conduct research in a variety of systems for appropriate payment of provider claims and research of patient billing issues in both clinical and revenue cycle systems utilized for transplant.
• Understands how to extract data from financial support systems. Maintains financial reports as directed.
• Monitors revenue cycle accounts and payment discrepancies as required
• Cross-trained for assisting in other financial roles within the transplant departmen

Job Requirements

Education: Bachelor’s degree or 4 years’ equivalent experience

• Experience: Minimum of 2 years of direct experience in hospital revenue cycle and/or transplant operations.
• Employee completes initial and ongoing training and competencies as defined by service

Line, facility and department/unit which are specific to the needs of the patient population served (if applicable).

Benefits

St. David's South Austin Medical Center, offers a total rewards package that supports the health, life, career and retirement of our colleagues. The available plans and programs include:

• Comprehensive benefits for medical, prescription drug, dental, vision, behavioral health and telemedicine services
• Wellbeing support, including free counseling and referral services
• Time away from work programs for paid time off, paid family leave, long- and short-term disability coverage and leaves of absence
• Savings and retirement resources, including a 401(k) Plan with a 100% match on 3% to 9% of pay (based on years of service), Employee Stock Purchase Plan, flexible spending accounts, preferred banking partnerships, retirement readiness tools, rollover support and financial wellbeing counseling
• Education support through tuition assistance, student loan assistance, certification support, dependent scholarships and a partnership with Galen College of Nursing
• Additional benefits for fertility and family building, adoption assistance, life insurance, supplemental health protection plans, auto and home insurance, legal counseling, identity theft protection and consumer discounts

Note: Eligibility for benefits may vary by location.

St. David's South Austin Medical Center, is a 368‑bed acute care hospital within St. David’s HealthCare, offering comprehensive specialty and sub‑specialty services. Key programs include a nationally accredited oncology program featuring the region’s only adult Transplant and Cellular Therapy Program; a Level II trauma center; advanced cardiac, stroke, and orthopedic services; full‑service maternity and newborn care; and four community emergency centers in Bee Cave and Bastrop.

The facility is affiliated with Texas Institute for Robotic Surgery, providing advanced robotic capabilities for orthopedics, open heart and lung procedures, complex GI surgery, surgical oncology, general and colorectal surgery, and urology. It was also among the first hospitals in Central Texas to integrate CT imaging with robotics for early lung cancer detection.

HCA Healthcare has been recognized as one of the World's Most Ethical Companies® by the Ethisphere Institute more than ten times. In recent years, HCA Healthcare spent an estimated $3.7 billion in cost for the delivery of charitable care, uninsured discounts, and other uncompensated expenses.

“Bricks and mortar do not make a hospital. People do.”- Dr. Thomas Frist, Sr.

HCA Healthcare Co-Founder

We are an equal opportunity employer. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.