Financial Analyst & Internal Audit

Position

FINANCIAL ANALYST & INTERNAL AUDIT

Columbia, SC

136

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The Financial Analyst & Internal Audit is primarily responsible for analyzing various reports to ensure supplies, claims, charges, transfers are reconciled and adjustments are completed. The position is responsible for Nextgen system administration and upgrades.

1. Provides decision support to Physicians and Management by running Nextgen reports as requested.

2. Responsible for Nextgen PM system administration and file maintenance.

3. Provides support during the evaluation of Nextgen upgrades and for the evaluation of new practice management systems under consideration.

4. Handles and completes the refunds report on a monthly basis (excluding PEN/PEP, WVA, and Injection Assistance Programs).

5. Conducts monthly audits of high-cost billable supplies for CEC and CESC including, but not limited to, injectable drugs, cross-linking drugs, and implantable stents. Audits will reconcile items ordered and received with billing records.

6. Verifies complete claims submission through the Background Business Processor (BBP) on a routine basis. Manually uploads insurance claims when the BBP fails and works to immediately resolve BBP issues.

7. Runs and reviews company transfer reports in coordination with the Billing Department. Makes proper account transactions as needed.

8. Reports inter-company transfer amount to Finance on a monthly basis.

9. Audits departmental-specific reports as needed.

10. Audits ACH posting on a routine basis.

11. Reviews and merges duplicate accounts for CEC and CESC.

12. Routinely audits patient collections to evaluate the accuracy of the amounts collected.

13. Reviews and properly adjusts deceased patient accounts.

14. Reviews all small balances and make proper adjustments.

15. Generates a monthly report to fix patient types for the Productivity report.

16. Provides additional reports to make proper adjustments:

• Adjustments greater than charges.
• Secondary and tertiary bad balance
• Opens encounters with zero-dollar balances

17. Provides details of all write-offs for the following on a monthly basis:
Authorization Denial Adjustment, Authorization Not Obtained, Bundled Services Adjustment, Failure to Follow-up in a Financial Analyst & Internal Audit Page 2 timely Manner, Global Denial Adjustment, Management Adjustment, Non-Covered Service, Not Medically Necessary, and Timely Filing Adjustment.

18. Provides financial analysis on specific service lines as requested.

20. Must comply with all HIPPA and safety policies, procedures, and regulations.

21. This job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. To meetthe business needs of the company duties, responsibilities, and activities may change at any time with or without notice.

Bachelor’s degree in Accounting or related field and 5 years’ experience in revenue cycle Administration for medical practices, ambulatory surgery centers or hospitals.

1. Well-organized, self-motivated with an ability to establish priorities and manage multiple projects concurrently.

2. Understanding of healthcare operations.

3. Strong customer service and conflict resolutions skills.

4. Strong analytical skills and attention to detail.

5. High-level understanding of coding and documentation rules and regulations.

6. Excellent communication skills both oral and written.

Full-time position with a work schedule of Monday through Friday 8:00am to 5:00pm.

Position operates in a professional office environment requiring minimal physical activity.

Building meets required ADA standards and we will make reasonable accommodations to enable individuals with disabilities to perform the essential functions of the job.

Physical demands include but are not limited to:

o The ability to sit, stand, walk, and use hands and fingers to operate a computer keyboard, mouse, and telephone to talk and hear.

o The ability to frequently sit and reach with hands and arms.

o The ability to occasionally lift and/or move up to 10 pounds.

o Must be able to utilize office equipment such as desktop/laptop computers, copiers, printers, scanners, telephones and calculators.

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