Financial or Bus Analyst Sr

Job Summary

Under limited supervision, the Business Analyst plays a critical role within Hospital Billing to pull data from disparate systems, analyzing data and improving process and outcomes.  The primary responsibility is to assess data and develop strategies to enhance operational efficiency and improve financial performance.  This role supports both Revenue Cycle related to revenue leakage that occurs because workflow isn't followed, workflow requires improvements or requires escalation with Managed Care Contracting and insurance companies to challenge policy and procedure for how they are processing claims.  The role will involve working with many different areas, facilitating meetings, and leading small projects that result in improvement of revenue leakage.

Mission Statement

Michigan Medicine improves the health of patients, populations and communities through excellence in education, patient care, community service, research and technology development, and through leadership activities in Michigan, nationally and internationally.  Our mission is guided by our Strategic Principles and has three critical components; patient care, education and research that together enhance our contribution to society.

Why Join Michigan Medicine?

• 2:1 match on retirement savings
• Excellent medical, dental, and vision coverage starting on day one of employment.
• Generous Paid Time Off (PTO) and paid holidays
• Opportunity for remote work is based on the ability to hit productivity and performance measures.  
• Flexible schedule 

Responsibilities*

• Data Analysis: collect, interpret and analyze revenue cycle data (billing, coding, operational metrics) to identify trends, inefficiencies and areas of improvement
• Process Improvement: Propose process improvements and partner with operational areas to implement
• Stakeholder collaboration: work closely with administrative, billing, clinical, IT and operational leaders to improve revenue leakage
• Report findings: Escalate issues and status to leadership. Use SBAR and PDCA formats for presentations and follow up. 
• Facilitate/lead workgroups: Follow up on action items, present findings, and escalate to leadership 
• Lead initiatives to reduce write-offs with support from department leadership
• Identify denial trends and perform root cause analysis.  Categorizes denials based upon root cause findings and distributes reports to applicable management and teams.
• Perform Work Queue Analysis: Use EPIC Work queues to report on data trends. 
• Proactively work with multidisciplinary teams within the organization to develop procedures to reduce the number of denials received through reporting of denials and education of denial trends.
• Assist with establishing and implementing denied claims process improvement initiatives and maintains the action plans to ensure plan objective are being obtained.   
• Research, develop and maintain a solid understanding of payer requirements, including filing limit, claim processing logic, coordination of benefits requirements, patient responsibility and authorization requirements.
• Maintains a strong understanding of payer contracts and payment methodologies to identify their correlation to denied claims. 
• Conducts relevant research on best practice methods to assist with completing the appeals process while staying informed with policy reforms, new regulations, billing changes, and accreditation/compliance requirements.
• Triages denied claims to identify those that should be appealed. 
• Performs other duties as assigned. These may include but are not limited to: Maintaining a current knowledge base of department processes, protocols and procedures, pursuing self-directed learning and continuing education opportunities, and participating on committees, task forces, and work groups as determined by management. 

Required Qualifications*

• Associate's degree/Bachelor's degree or equivalent combination of education and experience.
• 5+ years of experience in billing and/or denials management in hospital operations with a demonstrated understanding of revenue cycle with an emphasis on billing, coding, charge capture and reimbursement methodologies.
• Knowledge of medical terminology. 
• Basic knowledge of CPT's, HCPCS, and Revenue Codes.
• Basic knowledge of major insurance companies' billing policies to ensure compliance.
• Advanced knowledge of payor remittances.
• Advanced knowledge of insurance claim forms.
• Demonstrates advanced skills MS Office to include Word and Excel, including Pivot Tables.  Working knowledge of PowerPoint. 
• Experience analyzing billing data in Epic. 
• Strong analytical skills are necessary to collect, analyze and interpret denials data, resolve complex problems.
• Ability to organize, prioritize and manage multiple priority projects simultaneously.
• Highly motivated, self-starter with attention to detail and accuracy with excellent written, verbal, and interpersonal skills. Ability to work in a team environment as well as independently.
• Knowledge of health system regulatory guidelines, standards and experience in healthcare setting strongly desirable.
• Commitment to team support, participation, and excellence.
• Ability to work with various levels of personnel, demonstrate tact and discretion when receiving and relaying information.

Desired Qualifications*

• Coding/RHIT(A) Certification
• Experience creating SBARs and presenting problems at Leadership level
• Knowledge of University Health System policies, procedures, and regulations. 
• Experience with University systems including: MiChart/Epic, Outlook, Epremis(Change HC), Waystar, CHAMPS, Availity and other payer websites.
• Ability to stay abreast of Federal coding requirements and guidelines. 

Modes of Work

Positions that are eligible for hybrid or mobile/remote work mode are at the discretion of the hiring department. Work agreements are reviewed annually at a minimum and are subject to change at any time, and for any reason, throughout the course of employment. Learn more about the work modes.

Background Screening

Michigan Medicine conducts background screening and pre-employment drug testing on job candidates upon acceptance of a contingent job offer and may use a third party administrator to conduct background screenings.  Background screenings are performed in compliance with the Fair Credit Report Act. Pre-employment drug testing applies to all selected candidates, including new or additional faculty and staff appointments, as well as transfers from other U-M campuses.

Application Deadline

Job openings are posted for a minimum of seven calendar days.  The review and selection process may begin as early as the eighth day after posting. This opening may be removed from posting boards and filled anytime after the minimum posting period has ended.

U-M EEO Statement

The University of Michigan is an equal employment opportunity employer.