Business consultant serp_jobs.h1.location_city

Essential Job Functions

• Supports and models behaviors consistent with Billings Clinic’s mission, vision, values, code of business conduct and service expectations. Meets all mandatory organizational and departmental requirements. Maintains competency in all organizational, departmental and outside agency standards as it relates to the environment, employee, patient safety or job performance.
• Understands the overall workflow to proactively solve problems, provide analysis, and evaluate trends in the revenue cycle. Displays initiative to resolve 835 remittance issues including, but not limited to : unapplied cash, claim exceptions, and partial pays. Provide claims resolution to ensure accuracy in the process.
• Assists with inventory, supply and equipment acquisition and repair, and vendor relations.
• Conducts performance and payment audits for both internal and external audits. Supervises the collection of payment data and provides recommendations and resolution to audit results. Attends, reviews, researches, and responds to payer audits. Develops audit responses and correspondences with payer and escalates adverse audits to management.
• Provides proactive and ongoing follow-up and problem solving with insurance companies and pharmacy sites to identify trends, communicate proactively, and ensure accuracy in the revenue cycle process.
• Ensures optimal revenue cycle performance through evaluation, analysis, and problem solving. Provides analysis to stakeholders and constantly analyzes operations in an attempt to improve processes in order to provide better customer service and improve the revenue cycle.
• Reviews payments for accuracy, ensure collection according to contracts, and follows-up with insurance companies to leverage the revenue process.
• Oversees the creation of analysis consisting of proformas, IRR’s, capital requests, and business line opportunities.
• Collect and analyze data for fiscal impact of existing and proposed contracts, business lines, and product lines for both internal and external customers. Provide analysis, recommendations, and summary to stakeholders
• Understands contracts to achieve results and department metrics, including but not limited to : payer DSO equal or exceeds department goals, A / R percentage over 60 days equals or exceeds department goals, and timely submission of secondary payer billings equals or exceeds department goals.
• Maintains competency in all organizational, departmental and outside agency environmental, employee or patient safety standards relevant to job performance.
• Performs other duties as assigned or needed to meet the needs of the department / organization.

Minimum Qualifications

Education

Experience

Or an equivalent combination of education and experience relating to the above tasks, knowledge, skills and abilities will be considered. Employees that require a licensed or certification must be properly licensed / certified and the licensure / certification must be in good standing.