Apply all aspects of strategic, financial and accounting analyses to ensure the appropriate optimal reimbursement within the CHN via various audits to include but is not limited to: Compliance (before and after billing), Denial Review, Medicare Service Specific Reviews, Medical Necessity Reviews, Advance Beneficiary Notice, Observation, CCI and as issues or concerns present. As a liaison between the Admitting Department, Business Office and Clinical Areas, the incumbent will provide guidance and training as needed. May perform comprehensive studies including comparisons to actual results. Support service lines, programs and departments in achieving financial goals, improving processes and generating efficiencies.
Accountable for preparation and/or evaluation of statistical, financial, demographic and/or valuation data for internal and external customers including regulatory agencies, payers, and senior management of the organization. Record, report and/or monitor fiscal and budgetary operations while supporting the vision and direction of the organization and its various products/programs/service lines. Interpret and identify financial problems and research effective solutions. Communicate with customers, co-workers and management. Support efforts to manage change, innovation as well as foster teambuilding. Function as a liaison with Department Directors, Patient Financial Services, Physicians and Regulatory Payers (Federal, State, and County). Maintain direct contact with internal department directors and physicians regarding financial analysis (throughout the entire revenue cycle) of reimbursement with third party payers to maintain up to date information. External contact consists of federal agencies and patients. Maintain high level knowledge of compliance requirements relative to regulatory third party reimbursement and educating specific CHN department heads as appropriate. Review of clean claim billing, denials and medical necessity issues to ensure appropriate optimal reimbursement. Provides training sessions for selected department directors, physicians and staff members designed to reduce coding/billing errors. Perform other specialized financial and revenue analyses as required.
Level 2 ï¿½ Proficient (in addition to above duties) Design and implement routine or ad hoc reports. Consult and advise financial management on technical or operational problems identified through the accounting and reporting processes. Recommend changes and new procedures and protocols based on identified needs.
Level 3 ï¿½ Subject Matter Expert (in addition to above duties) Assist the Manager/Director as requested in review and update of department functions and procedure revisions. Give input to Manager/Director concerning operational procedures and budget planning. Assist in training, mentoring others in acquiring skills.
Qualifications: Education Required: Bachelor degree in Finance, Business, or Accounting with combination of education, education, training or equivalent. Preferred: Masterï¿½s Degree.
Experience Required: 4 years of auditing, medical reimbursement and insurance or relevant experience and direct experience in a complex health care provider organization. Preferred: 6 years relevant business experience, 2 years in healthcare industry.
Skills Required: Team building, problem solving, critical thinking, good interpersonal communication (both written and oral), technical knowledge in accounting and finance areas. Verbal and written communication skills.
Knowledge Required: Knowledge of CPT-4 and ICD-9 coding. Strong knowledge of Medicare, Managed Care, and other 3rd party payer as related to hospital operations. Knowledge of Accounting and Finance principles and financial analysis; knowledge of fiduciary responsibilities as related to the laws, rules and regulations as defined by the Federal, State and JCAHO statues. Preferred: Skilled Nursing Facility, hospital-based physician, professional fee billing. Basic knowledge of diagnosis codes.
Technology Required: Strong computer skills in business analytic tools such as Excel, personal computer applications. Preferred: Knowledge of healthcare computer systems.
Job: Finance and Accounting
Primary Location: Tucson, Arizona
Facility: Shared Services Center at Forbes
Job Type: Full-time
Shift Type: Days
Employment practices will not be influenced or affected by an applicantâ��s or employeeâ��s race, color, religion, sex (including pregnancy), national origin, age, disability, genetic information, sexual orientation, gender identity or expression, veteran status or any other legally protected status. Tenet will make reasonable accommodations for qualified individuals with disabilities unless doing so would result in an undue hardship.
Internal Number: 1905033735
About Shared Services Center at Forbes
“Tenet Healthcare Corporation is a diversified healthcare services company with 115,000 employees united around a common mission: to help people live happier, healthier lives. Through its subsidiaries, partnerships and joint ventures, including United Surgical Partners International, the Company operates general acute care and specialty hospitals, ambulatory surgery centers, urgent care centers and other outpatient facilities. Tenet's Conifer Health Solutions subsidiary provides technology-enabled performance improvement and health management solutions to hospitals, health systems, integrated delivery networks, physician groups, self-insured organizations and health plans.