Catholic Health · 8 hours ago
PFS Analyst
Melville, NY, US
Full-time
Onsite
Mid Level
3+ years expCatholic Health is one of Long Island’s finest health and human services agencies. The PFS Analyst is responsible for developing metrics to track performance and operations, conducting analysis, and providing recommendations for optimization and financial goals within the department.
Health Care
Responsibilities
Contributes to and consistently applies CH Services’ policies, procedures, and benefits to all customers and/or employees without discrimination
Employee conducts himself/herself in conformity with the HIPAA Compliance Program and applicable institutional policies and procedures for patient privacy. In addition, employee conducts himself/herself in conformity with the CHS Security policies and procedures
Builds system and hospital-specific A/R portfolios by payer, operational division and external vendors in multiple reporting PFS systems
Creates payment, adjustment and write offs analysis for specific payers, operational divisions and the system as a whole
Leads monthly analysis of account receivables by hospital and carrier plan including debits and credits. Summarizes and communicates trends in reimbursement, contract variances payment delays and staffing to leadership
Validates fee schedules against contracts; performs revenue modeling for specific payers and outlines risks and gains to contract terms
Works with Directors on recovery efforts tied to identified variances and denials by insurance carrier for managed care negotiations
Prepares external expense tracking, performance assessment and analysis. Proposes cost savings measures and efficiencies based on vendor performance
Collects data and prepares analysis of proposed payer-based settlements against open debits and credits
Conducts payment analysis in conjunction with Finance department to assess collection performance year over year
Conducts analysis of revenue impact associated with changes in payment models or other initiatives
Prepares monthly analysis of hospital revenue cycle performance
Works with Revenue Cycle and Managed Care team to identify and resolve issues related to timely payment
Updates issue lists and reports
Adheres to all organizational policies and procedures
Qualification
Required
Bachelor's degree required
Proficient in designing, building reports and analyses in various Microsoft based data analysis tools
Ability to analyze and accurately summarize complex claims data and effectively communicate conclusions
At least three years' experience with analysis preferable in a healthcare or managed care setting
Strong knowledge of the managed care environment including provider, payer, and employer
Preferred
Master degree preferred
Proven experience working with large and complex SQL databases preferred
Experience with hospital billing and or decision support systems a plus
Benefits
Generous benefits packages
Generous tuition assistance
A defined benefit pension plan
A culture that supports professional and educational growth
Company
Catholic Health
When it comes to health care, Long Islanders have a choice.
10001+ employees
Funding
Current Stage
Late StageLeadership Team
Sumita Yadav
System Vice President Operations & Cardiovascular Service Line
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