This site uses cookies. To find out more, see our Cookies Policy

EP Business Analyst in Nashville at Parallon

Date Posted: 4/4/2019

Job Snapshot

Job Description

Parallon believes that organizations that continuously learn and improve will thrive. That’s why after more than a decade we remain dedicated to helping hospitals and hospital systems operate knowledgeably, intelligently, effectively and efficiently in the rapidly evolving healthcare marketplace, today and in the future. As one of the healthcare industry’s leading providers of business and operational services, Parallon is uniquely equipped to provide a broad spectrum of customized revenue cycle services.


We are a wholly owned subsidiary of HCA, a Fortune 100 company with more than 200,000 employees and one of the nation's leading providers of healthcare services, operating over 170 locally managed hospitals and over 100 freestanding surgery centers in 20 states and the United Kingdom. HCA has been named one of the world's most ethical companies for eight years in a row. At HCA, we are driven by a single goal: the care and improvement of human life.
 
Job Summary

Documentation and analysis of system balancing, clean claim rates, payer acceptance rates, and system edit requests. Creation or modification of system billing edits to ensure appropriate claim results that meet payer, regulatory and provider requirements. Assist service centers, clients and payers regarding billing system processes and policies. The EP Business Analyst is considered to be the subject matter expert and the liaison between the SSC’s and Relay Health.
A background and operational experience in Healthcare Revenue Cycle IT Solutions or Billing is recommended. Specific experience and understanding of HCA’s Revenue Cycle applications (i.e. Relay Health, Patent Accounting, eRequest and Artiva) is desirable.
 
 
Duties (included but not limited to):

  • Analyzes daily balancing exceptions by service center to determine bridge routine rules that resulted in the discarding of the claim, reports results to appropriate service centers and suggests modifications in the bridge routine rules to eliminate future balancing exceptions.
  • Provides balancing exception trending information to manager and director with comments regarding peaks and valleys in data.
  • Publishes balancing exception reports, including reasons for exceptions and service center responses on imaging storage system.
  • Analyzes daily released claims to determine payer acceptance percentages and rejection rates, reviews claim rejections to determine reason for rejection, reports rejections to the appropriate service centers and assists the service center billing director in creating edits to prevent future payer rejections.
  • Provides payer acceptance trending information to manager and director with comments regarding peaks and valleys in data.
  • Publishes service center payer acceptance/rejection logs on imaging storage system
  • Publishes service center daily claim submission reports on imaging storage system.
  • Monitors the edit requesting system for edit modification requests; reviews request for completeness, appropriateness and receipt of approvals.
  • Analyzes edit requests to determine type of edit modification required; logs service orders with billing vendor for supplemental/payer edits or creates/modifies bridge routine edits for provider edits.
  • Creates/Modifies bridge routine edits in the billing test system.
  • Creates testing scenarios for new or modified bridge routines that include before and after examples and negative testing that fully satisfies edit testing policies and procedures.
  • Publishes all testing documentation on imaging storage system.
  • Monitors billing system service orders system to ensure all requests are appropriately and timely resolved.
  • Work requests involving adding/modifying/turning off Artiva Collection Pools.
  • Work emails related to Artiva Pool questions, research, and troubleshoot
  • Run Artiva or BOBJ reports when needed
  • Routinely corresponds with service center billing director to validate services provided are meeting their needs.
  • Assists co-workers in completing work assignments as necessary to ensure a high level of service is provided by the department.
  • Maintains listing of all supplemental edits and activation criteria by service center location.
  • Travel to service centers and/or other facilities for onsite work may be required.
  • Must have strong documentation skills, organization skills, and the ability to interact with team members cross-functionally
  • Demonstrates a customer orientation; establishes and maintains strong relationships with business owners and   develops a diverse network of relationships with various stakeholders.
  • Supports implementation projects, including training and communication.
  • Identifies impact of edit requests and works with stakeholders to identify options and recommendations.
  • Supports annual audit reviews (e.g. internal & external audit for Sarbanes Oxley, etc.) 



Job Requirements

Education
  • High school diploma or GED required.
  • Bachelor’s degree in information systems or healthcare-related field is preferred.
  • Relevant experience may substitute education requirements


Experience

  • At least two years Parallon service center experience required. Emphasis on Billing or IT&S preferred.
  • Experience with ePremis, Relay Health and/or SSI billing vendor software.
  • Experience with Claim Update File (CUF) or XML is preferred.
  • Experience with professional and institutional claims
  • Strong collaboration, facilitation, and data analysis skills
  • Working knowledge of the following applications:



o Microsoft Office (Word, Excel, Access, Power Point)

o Business Objects , Acuity reporting

o Microsoft SharePoint 

 

Benefits of working at Parallon
Our benefits package allows you to select the options that best meet the needs of you and your family. Benefits include 401k with a company match, paid time off, medical, dental, vision, flex spending for both health and day care, life insurance, disability, tuition reimbursement and student loan repayment, employee discount program, employee stock purchase program.
 
We are an equal opportunity employer and we value diversity at our company. We do not discriminate on the basis of race, religion, color, national origin, gender, sexual orientation, age, marital status, veteran status, or disability status.
 
#ParallonBCOM