Reimbursement Analyst, Boone Hospital

Job Description

Job ID: 1185906
Employment Status: Full-Time
Your Career. Made Better.

Boone Hospital Center is a 394-bed full service hospital located in Columbia, MO. It is a regional referral center located in the center of the state. The hospital provides progressive healthcare programs, services, and technology to people in 26 mid-Missouri counties. Although the hospital is full service, areas in which Boone Hospital Center excels are cardiology, neurology, oncology, surgical, obstetrical services, and numerous other specialties. The hospital maintains a 24-hour emergency center with hospital-based ambulance service and a helipad for incoming emergency air transportation.  Recognizing its excellence in nursing care, Boone Hospital Center has been certified as a "Magnet Hospital" by the American Nurses Credentialing Center.
 

Revenue management consists of the people, processes and technology that makes medicine better by creating a single instance for all BJC hospitals, integrated end-to-end revenue cycle management processes, and a seamless hassle-free experience for patient


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Role Purpose

Reviews payments and contractual allowances associated with HMO/PPO, Medicare, Medicaid, IPA, and Champus on inpatient and outpatient accounts to insure accurate reimbursement. Initiates appeals to third party carriers for erroneous reimbursement.


Responsibilities

  • Reviews payments and contractual allowances.
  • Monitors reimbursements from third party carriers as defined in contractual and federal or state agreements.
  • Processes payment discrepancies and identifies variances; researches contract terms; performs analysis of discrepancies; initiates appeals and processes refunds.
  • Identifies payment discrepancy patterns, proposing resolution via managed care payor representatives, managed care contracting, billing processes, etc.
  • Participates in regular meetings with primary managed care payor representatives. Presents payment discrepancy patterns utilizing actual claim examples.

  • Minimum Requirements

     

    Degree

  • High School Diploma or GED
  •  

    Experience

  • <2 years
  •  

    Supervisor Experience

  • No Experience

  • Benefits Statement

    Note: not all benefits apply to all openings

    -  Comprehensive medical, dental, life insurance, and disability plan options
    -  Pension Plan*/403(b) Plan
    -  401(k) plan
    -  Tuition Assistance
    -  Health Care and Dependent Care Reimbursement Accounts
    -  On-Site Fitness Center (depending on location)
    -  Paid Time Off Program for vacation, holiday and sick time

    *Pension does not apply to Memorial Hospital, Memorial Hospital East, Memorial Medical Group, Alton Memorial or Parkland Health Center


    Legal Statement

    The above information on this description has been designed to indicate the general nature and level of work performed by employees in this position. It is not designed to contain or be interpreted as an exhaustive list of all responsibilities, duties and qualifications required of employees assigned to this job.

     

    Equal Opportunity Employer