Financial Analyst Revenue Integrity General Hospital

Job Summary

Collect and prepare financial data, analyze fiscal accounting and related systems to effectively and efficiently report various aspects of financial activities and the financial position of the MSO's clients. Review claims and payment data to ensure accurate billing to and payments from all Commercial, Managed Care, and Governmental Payers in compliance with all payer contracts and fee schedules. Review, research, and document trends with a focus on identifying charging and documentation opportunities.

• Prepare financial feasibility studies, review and evaluate studies, and administrative planning studies as assigned.
• Prepare, analyze and maintain financial data for reporting, budgets, and forecasting.
• Analyze financial operation of physician practices, prepare recommendations and documentation to create and update fiscal service and related policies and procedures with respect to accounting systems.
• Conduct and assist in the presentation of fiscal educational sessions to prospective clients.
• Accumulate and maintain detailed records of clients' assets, liabilities, revenues, and expenses.
• Periodically review client contracts, vendors, payors, etc.
• Assist Director and/or Finance Manager with special projects.
• Attend meetings and participate on committees as required.
• Enhance professional growth through inservice meetings, educational programs, seminars, conferences, and workshops.
• Work closely with Payer Contracting Department to ensure accurate rates and payment terms are loaded in company-approved contract management systems used to monitor billing and payment activity.
• Ensure claims and payment data is loaded into company-approved claims and payment monitoring systems and resolve any discrepancies promptly.
• Monitor payments from contracted payers to ensure timely compliance with payment terms.
• Review reimbursement and variance reports to identify trends and discrepancies.
• Prepare detailed non-payment/underpayment reports and distribute to appropriate teams for resolution and follow up.
• Review denial reports to identify trends and recommend solutions.
• Use company-approved charge capture auditing systems to identify missed charges and work with departments to resolve issues.
• Perform other duties and responsibilities as assigned.

Financial analysis, accounting systems, contract and payer management, data reporting, problem‑solving, communication, and continuous improvement.

• Bachelor's Degree in Accounting, Business, Finance, or related field (required) with 3+ years of related experience; grant or sponsored project experience preferred.
• Alternative: 10 years of patient accounting experience and 2 years of analytical experience may substitute for a Bachelor's Degree and 2 years of financial/accounting experience.

• No certification, competency, or license required.

General Hospital, Charleston, WV, USA