Hospital Claims/Billing Analyst - Santa Monica, United States - SGA

Description

Software Guidance & Assistance, Inc., (SGA), is searching for an Hospital Claims/Billing Analyst for a Contract assignment with one of our premier Healthcare clients in Los Angeles, CA .

You will leverage your extensive theoretical revenue cycle knowledge as you take on a vast range of critical revenue issues. This will involve applying dashboards and processes for continuous analysis of complex revenue cycle functions while also auditing data input for all components of revenue cycle management. You will:

Responsibilities :

• A nalyze complex financial data
• Identify trends in revenue cycle operations
• Summarize data and present reports to leadership
• Serve as liaison with departments to thoroughly define reporting and information requirements
• Evaluate revenue cycle workflows to identify areas for improvement
• Oversee charge integrity, reconciliation, and charge linkages from ancillary charging systems
• Train patient financial services units on revenue cycle systems, processes and procedures
• Maintain compliance with government regulations, reimbursement issues, etc.
• Analyze hospital billing claims within the EHR and claim scrubber system
• Resolve claim errors, edits, and other holds
• Works with clinical and ancillary operational departments on correct coding, billing, and charging principles

Required Skills :

• Bachelor's degree in business, finance or related field
• CPC-H, CPC, or CCS coding certification is required
• 5+ years of experience with hospital billing systems and third-party billing requirements
• Experience in revenue integrity operations, clinical charge capture, charge master, or revenue cycle operations
• Proficiency with Microsoft Excel
• Knowledge of Tableau Reporting dashboards
• Understanding of Medicare/Medi-Cal claims processing guidelines
• Experience with EPIC EHR, Cirius Claim Scrubber, or other EHR system
• In-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycle
• Strong analytical and problem-solving abilities
• Excellent communication, interpersonal, and collaboration skills
• Proficiency in the use of Current Procedural Terminology (CPT), Healthcare Common Procedure Coding System (HCPCS), and revenue codes

Preferred Skills : SGA is a technology and resource solutions provider driven to stand out. We are a women-owned business. Our mission: to solve big IT problems with a more personal, boutique approach. Each year, we match consultants like you to more than 1,000 engagements. When we say let's work better together, we mean it. You'll join a diverse team built on these core values: customer service, employee development, and quality and integrity in everything we do. Be yourself, love what you do and find your passion at work. Please find us at .

SGA is an Equal Opportunity Employer and does not discriminate on the basis of Race, Color, Sex, Sexual Orientation, Gender Identity, Religion, National Origin, Disability, Veteran Status, Age, Marital Status, Pregnancy, Genetic Information, or Other Legally Protected Status. We are committed to providing access, equal opportunity, and reasonable accommodation for individuals with disabilities in employment, and our services, programs, and activities. Please visit our company to request an accommodation or assistance regarding our policy.