Business Analyst - ROPS Credits Team( Brentwood , TN )

Job Description:

This position reviews, analyzes, resolves, and trends credits from potential insurance company over-payments within department timeframes (SLA). This position also performs quality assurance reviews on the analysis conducted by the credit teams on refund creation and payor additional information requests, report development, and maintenance as well as communicates information relative to the Credits Team to the Manager, Director and Vice President of ROPS. ESSENTIAL DUTIES AND RESPONSIBILITIES.Prepare and analyze reports detailing current and historic credit balances of payors and treatment allocations; identify trends, variances, aberrant data and other information as needed Develop reports detailing current and historic performance of department teammates; identify trends, comparisons to established benchmarks and goals, workload analyses, forecasting models and other information as needed Provide reporting data to management and others in oral and written form Provide support to management in all facets of training and quality assurance, specifically related to performance trends, benchmarks, and other metrics as requested Identify root causes for credit balance creation and take appropriate steps to prevent potential future credit balances from payors Assist in the completion of accurate and timely reporting for quarterly Medicare Credit Balance Report (CMS-838) Perform additional process reviews as directed by the Credits Manager; identify opportunities for improvement and implement changes as directed Develop and maintain knowledge of all applicable department policies and processes as well as knowledge of all applicable billing and A/R related systems Work with other ROPS teams, Compliance and Legal Teams as necessary to resolve payor and contracting issues Execute projects as assigned by the Credits Manager related to credit resolution