Patient Financial Services Corporate Account Analyst – Alternative Payer Programs

2021-01-15T16:33:23-07:00January 15th, 2021|

CCRM Management

The Patient Financial Services Corporate Account Analyst (Analyst) – Corporate and Alternative Payer Programs plays a vital role in the revenue cycle management program at CCRM.  The Analyst coordinates and executes all financial and operational activity for such programs.  These programs include, but are not limited to industry unique alternative payers funding infertility care for employers who chose to use other than traditional insurance for employee infertility coverage, special alternative payer programs for international patients, the Company’s Donor Egg Bank program, and the Company’s Shared Risk Program.

The ideal candidate has keen analytical and financial skills together with being a seasoned professional in the various elements of the healthcare environment’s patient and insurance financial services arena, including a full understanding of the healthcare revenue cycle, operational analysis assessment, and synthesizing a great deal of information to maximizing revenue realization.

This position reports directly to CCRM Management Company’s Supervisor, Patient Financial Services.

CCRM is an industry leading pioneer in fertility science, research and advancement, offering access to a national network of award-winning physicians, a full suite of fertility services, innovative technology and cutting edge labs. CCRM is currently comprised of eleven locations spanning the U.S. and Canada with growth planned for continued network development on a domestic and international basis.  CCRM is proud to assist in building all kinds of families.

ESSENTIAL FUNCTIONS:

  • Coordinate the preauthorization of services for all patients across the network for all practices utilizing alternative payers.
  • Determine from the deconstructed billing analyzed at the various network practices whether the global services fees can be billed to the alternative payer for a given patient for a given episode of care.
  • Review patient medical records and determine whether services have been rendered to trigger the ability to bill for global services
  • Review and monitor outstanding alternative payer accounts receivables at the corporate level to ensure payment is received on a timely basis.
  • Upon receipt of payment, record and reconcile such payments received and perform intercompany transfer adjustments from the Corporate entity to the local network practices who rendered the services. Record other adjustments required on accounts when payments are recorded.
  • Take necessary steps on a timely basis to facilitate payment of accounts where payment has not been received.
  • Maintain active relationship with alternative payer representatives to monitor patients’ financial and treatment histories.
  • Serve as the contact person for all patients across the network who are making payments for participating in corporate level programs such as Donor Egg Bank or the ASSURE Shared Risked financial program.
  • Determine when the services rendered to Egg Bank Donors at the Practice sites are eligible for payment/reimbursement by the Company’s Donor Egg Bank, and facilitate such payment being made and recorded.
  • Communicate the receipt of funds received at the corporate level to clinical and financial staff at the Practice level so that patients can proceed with their care.
  • Perform all functions related to financial balancing and close-out as specified.
  • Possess a sincere desire to serve patients.
  • Possess a strong aptitude for handling financial analysis and recordation of financial activity.
  • Conceptually and in practicality grasp navigation through the various software applications used in executing the tasks associated with this position.
  • Advocate for patients to facilitate the financial actions necessary as a pathway for their care.
  • Ensure a timely response, per policy, to all patient inquiries, via either phone, portal messaging or in person, regarding their account and insurance related matters.
  • Serve as a resource to Physicians, Nurses and Patient Care Coordinators regarding any possible impact program limitations or requirements may have on the patient’s care plan.
  • Serve as a resource to Patient Account Representatives performing Financial Review, when questions arise regarding specific patient’s accounts.
  • Attend scheduled team meetings as an active and contributing participant in the Patient Care Team.
  • Engage in an iterative continuous improvement process to insure the effectiveness of the above set-forth policies, procedures, methodologies, and workflows. Make recommendations for adjustments where indicated to optimize efficiencies for staff and reliability of output for financial and operational reporting purposes, resulting in best-in-class practices and results.
  • Engage in a collaborative process with fellow colleagues to bring about the best possible experience for the patient.
  • Participate in and be an effective contributor in regular and ad-hoc meetings as necessary to achieve Practice and Corporate objectives.
  • Other duties as assigned.

POSITION REQUIREMENTS:

  • Bachelor’s degree in Healthcare Administration, Finance, Accounting or other business areas strongly preferred, or equivalent relevant professional work experience.
  • 2+ years of experience in a professional work environment, preferably in healthcare.
  • Experience in financial analysis or patient financial services in women’s healthcare, specifically infertility, strongly preferred.
  • Must enjoy serving patients and interacting with them.
  • Strong proficiency with Microsoft Office programs with an advanced skills in Microsoft Excel.
  • Strong analytical skills and the ability to read, generate, and analyze reports effectively.
  • Superior judgment and decision-making skills.
  • Strong ethics and high level of personal and professional integrity.
  • Excellent customer service skills with high expectations to consistently delivery quick responses and provide an exceptional experience for all employees and managers.
  • Excellent interpersonal and communication skills, an outgoing personality, with a professional demeanor and positive attitude with the ability to communicate positively and professionally with patients and staff members at all levels.
  • Excellent written and verbal communications skills.
  • Excellent organizational skills with an ability to multitask and effectively prioritize.
  • Exceptional personal and professional integrity and strong work ethics.
  • Demonstrated ability to be a team player and possess a willingness to perform duties as assigned or delegated.
  • Be a motivational force by exemplifying the company vision, mission, values, and culture.
  • Strong ability to maintain confidentiality and exercise discretion regarding confidential and sensitive information.
  • Maintain confidentiality of all work information.
  • Exhibit courteous, compassionate and respectful treatment of internal and external customers.
  • Displays a positive attitude and flexibility in changing situations.
  • Participate in identifying problems and suggesting solutions.

WORK ENVIRONMENT

This job operates in a professional office setting performing predominantly sedentary work. This role routinely uses standard office equipment. While performing the duties of this job, the employee is required to regularly communicate with others. Employee is required to have close visual acuity to perform activities such as preparing and analyzing data and figures on a computer terminal, extensive reading, and operation of standard office machines and equipment. The physical demands described here are not all-inclusive but are generally representative of those that must be met by an employee to successfully perform the essential functions of this job.

EQUAL EMPLOYMENT/ANTI-DISCRIMINATION

CCRM is an equal opportunity employer and does not discriminate on the basis of Race, Color, Religion, Creed, National Origin, Ancestry, Sex, Pregnancy, Age, Sexual Orientation (including transgender status), Physical or Mental Disability, Marriage to a Co-Worker, or for anyone engaging in Protected Activity (opposing a discriminatory practice or participating in an employment discrimination proceeding). Additionally, this employer does not tolerate any employees engaging in discriminatory behavior based on any of the aforementioned protected classes. 

PRE-EMPLOYMENT REQUIREMENTS

All offers of employment by this employer are conditional upon the incumbent’s successful completion of pre-employment screenings, including a criminal background check, drug screen, educational and prior employment verification, professional reference checks, and verification of the incumbent’s eligibility and authorization to work in the United States.

COMPENSATION & BENEFITS

CCRM proudly offers a competitive and comprehensive compensation and benefits package to full-time employees, which includes medical, dental, vision, life, disability an accidental injury insurance, and a 401(k) retirement plan with company match.

To apply for this job email your details to crandall@ccrmivf.com