Business Analyst III - Patient Financial Services - FTE - Days

Grady Health System - Atlanta, GA

Full-time - Mid Level

Atlanta, GA

Hospitals

About the position

The Business Analyst III in Patient Financial Services at Grady Health System is responsible for analyzing payments received from contracted payers to ensure appropriate reimbursement for the hospital. This role involves conducting quantitative comparisons and regular analysis of payment variances, as well as collaborating with various departments to resolve issues related to denials and underpayments.

Responsibilities

• Conduct regular analysis of payments received from contracted payers.
• Make quantitative comparisons to determine appropriate reimbursement.
• Analyze performance trending reports related to denials and payment variance.
• Manage denial resolution functions, both electronic and manual.
• Review payer contracts and underpayment variance functions.
• Ensure compliance with Medicare, Medicaid, and Managed Care billing regulations.
• Utilize hospital billing terminology and knowledge of CPT, ICD-9, and HCPCS codes.
• Collaborate with internal and external departments to resolve enterprise-wide challenges.

Requirements

• Bachelor's degree in Finance, Accounting, Healthcare Administration, Business, or related area.
• 3+ years of experience in hospital business office account follow-up, including zero payment and denials resolution.
• Hands-on knowledge of denial management functions and payer contracts.
• Experience with Medicare, Medicaid, and Managed Care billing regulations.
• Familiarity with UB-04 and HCFA 1500 claims forms billing and follow-up activities.
• Proficiency in Microsoft Office Suite, including Access, Excel, Word, PowerPoint, and Visio.
• Excellent communication, time management, and organizational skills.

Nice-to-haves

• Healthcare Financial Management Association (HFMA) certification.
• CPAR certification, Advanced CPAR or CPAM preferred.
• Experience within a large academic facility.
• Siemens INVISION and/or Epic experience preferred.
• Experience in process re-engineering, project planning, and management.

Benefits

• Full-time position with competitive salary.
• Opportunities for career advancement within Grady Health System.