Hybrid Infusion Cost and Reimbursement Analyst bei Austin Regional Clinic

ABOUT AUSTIN REGIONAL CLINIC:

Austin Regional Clinic has been voted a top Central Texas employer by our employees for over 15 years!   We are one of central Texas’ largest professional medical groups with 35+ locations and we are continuing to grow. We offer the following benefits to eligible team members: Medical, Dental, Vision, Flexible Spending Accounts, Time Off, 401(k), EAP, Life Insurance, Long Term Disability, Tuition Reimbursement, Child Care Assistance, Health & Fitness, Sick Child Care Assistance and Development. For more information visit https://www.austinregionalclinic.com/careers/

PURPOSE

The Infusion Cost and Reimbursement Analyst will be a key resource in ensuring timely and accurate analysis of infusion cost and reimbursement.  This position requires the ability to analyze claims data and expense reporting to provide insight into profitability of the infusion department. The position requires the ability to communicate equally well with physicians, management, accounting and billing individuals. An excellent blend of analytical, technical and communication skills in a team-based environment is essential for this role. Carries out all duties while maintaining compliance and confidentiality and promoting the mission and philosophy of the organization.

ESSENTIAL FUNCTIONS

• Meets with end users to gain a better understanding of the business needs and collaboratively identify best practice solutions and define report requirements.
• Routinely observes processes and workflows in the clinics to better understand reporting context.
• Tracks appeals and recoveries and performs regular follow up on outstanding appeals.
• Evaluates underpayments for possible overturn opportunity and provides recommendations to leadership.
• Collaborates routinely with Purchasing, CBO and other departments for efficient resolution of issues.
• Provides recommendations for changes to purchase and billing as well as therapy for infusion department.
• Responsible for having a clear understanding of the data and end user workflow to validate accurate results and reconcile discrepancies when necessary.
• Validates cost and reimbursement reports by comparing to actual data.
• Creates user-friendly reporting solutions that guide decision-making, including dashboards, ad hoc reports, and data extracts.
• Creates custom reports and edits existing reports within Epic reporting tools.
• Communicates project timeline estimates and deliverable status to leadership and others.
• Monitors the performance of reports and takes corrective action to optimize or improve the performance as problems arise.
• Reviews reports to improve accuracy, functionality, and consistency.
• Identifies and escalates consistent issues and trends with payers to support leadership in meeting with payers to resolve issues.
• Participates in meeting with management and physicians as needed.
• Maintains compliance with corporate quality assurance policy and required documentation.
• Adheres to all company policies, including but not limited to, OSHA, HIPAA, compliance and Code of Conduct.
• Regular and dependable attendance.
• Follows the core competencies set forth by the Company, which are available for review on ARC SharePoint.

OTHER DUTIES AND RESPONSIBILITIES

• Works collaboratively with on-site teams as well as support departments.
• Performs other duties as assigned.

QUALIFICATIONS

Education and Experience

Required: 

• Bachelor’s degree with technology, accounting or business and one (1) or more years of related healthcare database experience

High school diploma or equivalent and five (5) or more years of related technology, accounting or healthcare experience, preferably in infusion.

Preferred: 

• Medical billing or business office experience.
• EPIC experience.
• Claims denial management experience.

Knowledge, Skills and Abilities

• Ability to engage others, listen and adapt response to meet others’ needs.
• Ability to align own actions with those of other team members committed to common goals.
• Excellent computer and keyboarding skills.
• Expert level knowledge of Microsoft Excel.
• Proficient in Microsoft Access.
• Advanced working knowledge of relational database concepts.
• Knowledge of CPT and ICD-10 coding.
• Experience with product administration and report writing software to deliver reporting solutions to users.
• Advanced analytical and quantitative skills.
• Ability to apply knowledge and acquire new technological skills independently.
• Excellent verbal and written communication skills.
• Excellent customer service skills.
• Excellent interpersonal & problem-solving skills.
• Ability to work in a team environment.
• Ability to manage competing priorities and meet deadlines in a multi-task environment.
• Ability to perform job duties in a professional manner at all times.
• Ability to understand, recall, and communicate, factual information.
• Ability to understand, recall, and apply oral and/or written instructions or other information.
• Ability to organize thoughts and ideas into understandable terminology.
• Ability to apply common sense in performing job.

Periodic travel will be required to ARC Medical Plaza Specialty, Far West Medical Tower, Round Rock, Kyle, and Southwest.