Revenue Cycle Analyst - Financial Clearance

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CHOP is committed to building an inclusive culture where employees feel a sense of belonging, connection, and community within their workplace. We are a team dedicated to fostering an environment that allows for all to be their authentic selves. We are focused on attracting, cultivating, and retaining diverse talent who can help us deliver on our mission to be a world leader in the advancement of healthcare for children.

We strongly encourage all candidates of diverse backgrounds and lived experiences to apply.

A Brief Overview
Under the supervision of the Director of PFS (Patient Financial Services), this position will manage the day-to-day data collection and analytic actions required to produce meaningful information to staff and management. This position requires a high degree of pro-active involvement and an analytical approach to appropriately maintain the integrity of sensitive, detailed information pertaining to patients, medical record keeping and financial transactions within CHOP financial systems and PFS related sub-systems, as they complete process oriented and departmental tasks.

This position also serves as a source for various departments within patient financial services including Hospital and Physician and other departmental stakeholders for matters related to process improvement. They are responsible for the implementation and reporting of a robust quality review program for staff and service site-specific operations. This creates a routine of process breakdowns and results of productivity standards, with an understanding of why standards are not being met with correlated accountable action items for staff and management.

The project management component of this position includes the management of department led committees and initiatives, creation of agendas, monitoring of progress and takeaways, as well as adherence to timelines.

What you will do

• Manage Data Analysis & Quality Assurance for PFS Departments, tasks include:
• Providing support for Hospital Billing & Collections, Professional Billing & Collections or Support Services, and the other areas in compiling reports in various formats
• Assisting with operationalizing the KPI metrics activities needed for leadership to manage operations and report to various committees
• Running and distributing metric reports which quantifies and compares the actual and expected
• Pulling data from source systems, creating analytic summaries, ensuring the validity/accuracy of data presentations
• Manipulating data & performing analysis through complex use of Microsoft Excel and other analytic tools
• Utilizing EPIC reporting and Slicer Dicer to create standard reports that leaders can use regularly
• Identifying payor trends and summarizing to management
• Documenting findings and root cause(s)
• Analyzing productivity/production standards. Create various dashboards to assist with monitoring department performance
• Supporting internal projects by initiating, leading, and resolving data investigations and communicating to internal and external personnel
• Gathering relative documents from payor websites to stay assist department with staying current as needed
• Documenting and dissemination of operational policies and procedures, and documenting workflows as needed
• Assisting in compiling reports in various formats
• System Issues Resolution and Process Improvement within CHOP financial systems and related PFS sub-systems, tasks include:
• Identifying, reporting and tracking all system related operational issues to minimize negative impact; implementing solutions and monitor long-term fix is operational.
• Maintaining a leadership role in all CHOP financial systems and related PFS sub-systems installs and upgrades.
• Providing/offering creative solutions to key challenges as identified from daily operations
• Assisting Subject Matter Experts in making data driven recommendations
• Project Management Tasks: support leaders in department led committees, meetings, projects by creating and maintaining agendas, keeping projects on task, managing takeaways, documentation and next steps
• Daily KPI tracking - monitor daily numbers to show data trends and identify areas of opportunities
• Adhere to and maintain required levels of productivity and quality performance KPIs
• Maintain up-to-date coding knowledge by reviewing materials disseminated/recommended by the Physician Staff, Coding and CDI Leadership
• Participate in Coding department meetings and educational events as assigned
• Maintain a collegial working relationship with CDI and Coding and Client Success partners
• Provide professional analytical services to optimize business performance
• Provide documentation feedback to Coders and Clinical Documentation Improvement Specialists (CDIS) as needed
• Perform analysis of chart completion and proactively identify opportunities, trends, and recommended enhancements
• Assist in special projects and other roles and responsibilities as needed to support Accuity
• Performs miscellaneous job-related duties as assigned

Education Qualifications

• Bachelor's Degree Required
• Master's Degree Preferred

Experience Qualifications

• At least three (3) years work experience in a healthcare finance, accounting, billing, business role/environment Required

Skills and Abilities

• Must have proficiency in Excel (use of pivot tables, data connections, advanced formula use, presentation and graphics) (Required proficiency)
• Must have excellent presentation skills and be very comfortable presenting findings and recommendations to multiple levels of staff & management (Required proficiency)
• Must possess strong understanding of Patient Financial Services procedures and operations (Required proficiency)
• Excellent communication skills and demonstrated organizational skills. (Required proficiency)
• Strong interpersonal skills a must. (Required proficiency)
• Must be organized, analytical, and detail-oriented. (Required proficiency)
• Ability to work independently towards specific goals and objectives and provide recommendations for improvement. (Required proficiency)
• Must be able to implement procedural changes; monitor ongoing progress. (Required proficiency)

Licenses and Certifications

• Certified Patient Financial Services Specialist - Hospital Business Institute - within 6 months - Required or
• Certified Revenue Cycle Representative (CRCR) - Healthcare Financial Management Association - within 6 months - Required

To carry out its mission, CHOP is committed to supporting the health of our patients, families, workforce, and global community. As a condition of employment, CHOP employees who work in patient care buildings or who have patient facing responsibilities must be fully vaccinated against COVID-19 and receive an annual influenza vaccine. Learn more.

Employees may request exemptions for valid religious and medical reasons. Start dates may be delayed until candidates are immunized or exemption requests are reviewed.

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