UNC Health · 6 hours ago
Reimbursement Analyst
UNC Health is an inclusive organization dedicated to improving the health and well-being of its communities. The Reimbursement Analyst performs operational and financial analyses to maximize billable charges, working closely with clinical managers to improve revenue flow and manage the billing process for specialty pharmacy medications.
Addiction TreatmentHealth CareHealth DiagnosticsHospitalNon ProfitWellness
Responsibilities
Assesses accuracy of billing and conducts reimbursement audits. Recommends, and assists in implementing corrective actions resulting from reviews
Assists in designing specific procedures and systems changes. Coordinates with external organizations (including drug manufacturers and insurance carriers) on projects and issues to maximize reimbursement
Educates physicians and other clinic and administrative staff on concepts, issues and processes related to reimbursement. Prepares communications and training materials. Drafts technical documentation such as user guides for reimbursement systems and procedures
Monitors and analyzes a variety of data from internal and external sources to identify trends in reimbursement denials. Develops and execute reports which aid in analysis of financial data to determine root causes of problems. Charts and tracks revenue-related changes (e.g., charges, receipts, third party sponsorship, collection rates) over time
Prepares analyses of department fee schedules and makes recommendations for changes, considering new or changed CPT codes and other relevant information. Produces impact projections to assess the viability of any proposed changes to fee structures
Prepares appeals of third party decisions. Conducts background research collects data assembles documentation and follows up with agency to obtain decisions. Serves as liaison and manages records and files of such appeals. Directs mass claim refiles
Recommends changes to processes and other revenue structures. Recommends additional opportunities for increased revenue based on analyses
Serves on cross-departmental project teams to design, plan and implement changes in the operational processes and programming to enhance current processes and develop more efficient processes. Serves as special projects coordinator in systematic problem resolution
Qualification
Required
Bachelor's degree in an appropriate discipline (or equivalent combination of education, training and experience)
If a Bachelor's degree: No experience required
If an Associate's degree: Four (4) years of experience in business analysis and planning, accounting, finance, health care administration or data base management/analysis
If a High School diploma or GED: Eight (8) years of experience in business analysis and planning, accounting, finance, health care administration or data base management/analysis
Benefits
UNC Health benefits
Company
UNC Health
Our mission is to improve the health and well-being of North Carolinians and others whom we serve.
Funding
Current Stage
Late StageLeadership Team
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