Reimbursement Analyst II

Job Description Summary

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Job Description

Coordinates, interprets and monitors all pertinent information relative to the revenue cycle departments.  Demonstrates a high level of understanding of departmental operations and workflows.  Prepares reports for Department and faculty.  Analyzes reports which measure performance and effectiveness of the revenue cycle; detects trends or problems and makes recommendations for corrective action. 

Maintains current knowledge of billing and reimbursement rules as designated by the Centers of Medicare and Medicaid Services (CMS), by various managed care companies, and other payers.  Communicates all changes to faculty and department.

Analyzes accounts receivable and facilitates expeditious resolution.  Identifies trends in payments and denials.  Conducts financial analysis of payment trends for all services, reports findings and makes recommendations for improvement.  Develops, distributes, and explains statistical reports to faculty to optimize billing.  Conducts monthly/quarterly meetings to review revenue activities and develop action plans to improve financial performance. 

Prepare and present monthly reporting to departments/faculty/physicians and make recommendations.

Review and keep abreast of changes in coding as well as documentation requirements. Communicates regularly and develops good working relationships with all areas of the revenue cycle to include managers and staff to resolve unpaid claims.  Provides technical expertise in reimbursement and coding.

Develops performance indicators and quality control reports to identify trends and disseminate information to the appropriate external and internal parties.

Trouble shoot issues as they present themselves on data.

Perform other duties as assigned.

Additional Job Description

Required Minimum Education and Requirements: Bachelor's Degree in Business Administration, Accounting, Management Information Systems or a related discipline required. MHA preferred. Excellent computer skills (MS Word, PowerPoint, Excel) with advanced knowledge of financial systems, to include skills with other business intelligence and analytical tools.

Degree of Supervision: Must be able to work independently under the direction of the Reimbursement Manager.

Physical Requirements: Continuous requirements are to perform job functions while standing, walking and sitting. Ability to bend at the waist, kneel, climb stairs, reach in all directions, fully use both hands and legs, possess good finger dexterity, perform repetitive motions with hands/wrists/elbows and shoulders, reach in all directions. Maintain 20/40 vision corrected, see and recognize objects close at hand and at a distance, work in a latex safe environment and work indoors.  Frequently lift and/or carry objects weighing 20 lbs (+/-) unassisted. Lift from 36” to overhead 15 lbs.  Infrequently work in dusty areas and confined/cramped spaces.

If you like working with energetic enthusiastic individuals, you will enjoy your career with us!

The Medical University of South Carolina is an Equal Opportunity Employer. MUSC does not discriminate on the basis of race, color, religion or belief, age, sex, national origin, gender identity, sexual orientation, disability, protected veteran status, family or parental status, or any other status protected by state laws and/or federal regulations. All qualified applicants are encouraged to apply and will receive consideration for employment based upon applicable qualifications, merit and business need.

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