University of Rochester Financial Analyst - 215362 in Rochester, New York
Full Time 40 hours Grade 054 URMC Payer Contracting & Reimb
8 AM-5 PM
The Contracting Analyst serves as a key member of the Payer Contacting and Reimbursement Department.
The Contracting Analyst will work with the contracting department in regards to data and revenue analysis, issue resolution as it relates to new and existing agreements, and providing support for other departments within the organization for contract interpretation and implementation.
The Contracting Analyst will be the lead person responsible for the contracting process in regards to Managed Behavioral Health Organizations and will be the main point of contact to provide support for that service category to departments within URMC.
Responsible for keeping abreast of URMC behavioral health reimbursement and health care industry regulations. Maintain record of regional third-party payer and employer group MBHO network relationships, accounts receivable performance data and revenue recovery resolution project statuses. Troubleshoot any reimbursement compliance issues which generally arise with payers and perform any analyses required.
Conduct routine research and required analyses to obtain payer behavioral health reimbursement criteria, formulas and rates. Develop, trend and audit health plan and MBHO negotiated reimbursement rates. Summarize the impact of behavioral health payment reimbursement agreements and regulations on Strong Memorial Hospital’s budget. Build, maintain and insure the integrity of behavioral health rates in the contract modeling system, PC reimbursement applications and tools.
Responsible for reviewing assigned single case agreement proposals, formulating reimbursement rates with justification and notifying requestors of URMC’s determination.
Prepare and submit facility, intent to contract, new site and provider information verification credentialing documentation for Strong Memorial Hospital and Highland Hospital. Maintain a resource library of facility certificates, accreditations, evidence of enrollment and other essential documents.
Serve as the behavioral health Payer Contracting and Reimbursement revenue cycle liaison for hospital-based revenue cycle stakeholder departments and Information Systems. Provide contract and regulatory agency advisory support to ensure the accuracy of the billing rates, resolve payer issues and support payer revenue recovery initiatives. Work with Patient Financial Services to maintain an ongoing payer issues log for resolution. Attend health plan and MBHO payer relations resolutions meetings. Maintain ongoing knowledge of URMC’s revenue cycle and business intelligence systems, admitting and registration procedures and accounts receivable collection practices.
Perform other URMC Payer Contracting and Reimbursement financial reporting, analyses and duties based on departmental priorities and URMC’s strategic plan.
Bachelor's degree in Accounting or Business Administration and 4 years of related experience; or an equivalent combination of education and experience is required. Graduate work / Masters Degree, and/or CPA, progressively responsible health care financial and reimbursement experience; or an equivalent combination of education, ongoing professional development and experience. Advanced competency with Microsoft Office Professional and health care reimbursement experience, experience with hospital patient access, accounting and revenue cycle systems, McKesson Performance Management, contract modeling and facility credentialing is preferred.
How To Apply
All applicants must apply online.
EOE Minorities/Females/Protected Veterans/Disabled