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    Operations Analyst - Charleston, United States - CAMC Health System

    CAMC Health System
    CAMC Health System Charleston, United States

    1 week ago

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    Description
    Position Overview

    This job focuses on investigating and resolving issues that cause delays in processing insurance accounts or payments.

    Role and Responsibilities

    • Providing guidance and training to staff to prevent recurring problems with insurance accounts.
    • Analyzing trends to pinpoint the root causes of billing issues.
    • Staying up-to-date on Federal and state billing regulations and guidelines.
    • Preparing and reviewing reports and documents with the team when necessary.
    • Identifying areas for enhancing work processes within MMS CBO/Practice.
    • Recognizing issues beyond standard processes and escalating them appropriately.
    • Identifying and addressing incorrect reimbursement and coding problems.
    • Applying necessary adjustments following contracts or state regulations.
    • Ensuring proper follow-up on reconsiderations sent for payment.
    • Communicating with payors to resolve issues effectively.
    • Performing additional tasks as delegated.
    Requirements and Skills


    Knowledge of Patient Groups (Applies to roles involving direct patient interaction): The employee must acquire and demonstrate the necessary skills and knowledge to provide appropriate care based on patient ages specified by the department.

    Specifically, the employee should exhibit proficiency in: 1) obtaining and interpreting patient-related information; 2) understanding growth and development; and 3) recognizing the range of treatment required by patients.

    Skill DemonstrationCandidates must showcase their competencies during initial orientation and ongoing assessments to execute tasks and additional duties outlined in the job description and departmental competency checklist.

    Core Responsibilities(Duties common across all roles)1. Meet documented education prerequisites.2. Exhibit positive interactions with customers and colleagues.3. Adhere to the attendance policy of the organization.4. Engage in quality improvement initiatives within the department and institution.5. Ensure cost-effective work practices.6.

    Abide by departmental pay practices and scheduling regulations, including overtime, various shifts, and on-call duties.7.

    Align with the organization's mission and strategic objectives.8. Adhere to organizational and departmental policies and procedures.9. Perform any other assigned duties.

    Educational Qualifications

    • Bachelor's Degree (Mandatory)
    Experience: 3 years of relevant experienceSubstitution: An Associate Degree in a related field with 5 years of experience can replace the Bachelor's degree requirement and 3 years of experience

    Professional Credentials

    • No Certification, Competency, or License Needed
    Working Hours: Days

    Employment Status: Full-Time Regular

    Location: General-MSOB

    Job Site: US:WV:Charleston

    Talent Acquisition Specialist: Anita J. Ferguson
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