Exl Service

  • Healthcare Analyst - Home Health Care and RUG / SNF

    Job Location US | US | US | US-FL-Jacksonville
    ID
    2018-6249
    Group
    SCIO Healthcare Analytics
    Type
    Regular Full-Time
  • Overview

    EXL/SCIO Health Analyticsis looking for a Healthcare Analyst—Home Health Care and RUG / SNF. This can be home office opportunity with preference to Jacksonville, FL location.

    Responsibilities

    Responsibilities:
    • Works as part of the diverse Selections team as with autonomy, accountability and team efforts. Ability to self-manage, open to learning and dynamic environment.
    • Researches and documents forthcoming initiatives from CMS and Private Insurance carriers.
    • Performs requested Medicare, Commercial and Medicaid research for client programs, formats and engages in required communication and team meetings.
    • Assists in the building of queries and review of queries in Payment Integrity Programs.
    • Willingness and skill to assist current coding staff with audits and audit questions.
    Requirements:
    • Comply with HIPPA and other regulations regarding confidentiality of information
    • Previous billing background preferred.
    • Insurance concepts and reimbursement methodologies especially as it pertains to CMS directives, etc.
    • Understanding of payment methods such as DRG, Percent of Bill, Per Diem, Outlier, RUG, HIPPS, etc.
    • Experience with Oasis, Per-diem, payment types for Home Health Care. Prefer Oasis Certification.
    • Experience with Minimum Data Set and RUG payment types, Skilled Nursing Facility payments..
    • Broad understanding of the current health care environment (commercial, Medicare, Medicaid, etc.)
    • Comply with HIPPA and other regulations regarding confidentiality of information

    Qualifications

    Minimum Qualifications:
    • Strong familiarity with insurance carrier’s guidelines/policies/certificates of coverage.
    • Nursing degree with billing experience in the Home Health Care sector.
    • Broad understanding of the current health care environment (Commercial, Medicare, Medicaid, etc.)
    • Clear understanding of Billing forms, Coding rules, Revenue Codes, Therapy types, Home Infusion, Bill Types, Face to Face.
    • Strong and efficient communication skills both oral and written. Detail oriented and well organized.
    • Mid-level or higher Excel experience
    • Exceptional Candidate will:
    • Be College or University prepared.
    • Have an ability to work in the Jacksonville, Florida office.

    EEO Statement

    EEO/Minorities/Females/Vets/Disabilities

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