Denial Analyst, Utilization Review

Job Description

At UC Health, we're proud to have the best and brightest teams and clinicians collaborating toward our common purpose: to advance healing and reduce suffering.

As the region's adult academic health system, we strive for innovation and provide world-class care for not only our community, but patients from all over the world. Join our team and you'll be able to develop your skills, grow your career, build relationships with your peers and patients, and help us be a source of hope for our friends and neighbors.

UC Health is committed to providing an inclusive, equitable and diverse place of employment.

About University of Cincinnati Medical Center

As part of the Clifton Campus of UC Health, Greater Cincinnati's academic health system, University of Cincinnati Medical Center has served Greater Cincinnati and Northern Kentucky for nearly 200 years. Each year, hundreds of thousands of patients receive care from our world-renowned clinicians and care team. Our experts utilize the most advanced medical knowledge and technology available, providing a level of specialty and subspecialty medical care that is not available anywhere else in Greater Cincinnati.

UC Medical Center is also home to medical breakthroughs- our physician experts conduct basic, translational and clinical research, leading to new therapies and care protocols, and connecting patients to the latest and most advanced treatments. UC Medical Center houses Greater Cincinnati's only Level I adult trauma center, which includes the right mix of specialist and medical resources available at a moment's notice for a wide variety of the most complex medical conditions and injuries.

Responsibilities

Responsible for implementing and supporting designated software applications utilized in Patient Financial Services/Revenue Cycle areas in accordance with departmental standards and procedures. Work as a liaison with IS&T and third party vendors to apply system functionality and upgrades, as well as testing and validation. Analyst will develop and generate reports utilizing a number of different applications. Analyst will also be responsible for analyzing the outcome of reports to maintain integrity and identify key strategic trends.
  • Responsible for supporting third party systems; maintaining, trouble-shooting and acting as a liaison to vendor:
  • Provides documented solution alternatives to problems/issues to support offered solutions.
  • Executes application design changes according to established procedures.
  • Develops detailed, written, and inclusive application test plans.
  • Performs complete testing of software and validates application requirements are met.
  • Provides user training and/or support to customers, training, and operations staff.
  • Provides timely and accurate support to resolve application errors and user reported problems.
  • Documents application request using the Service Request system.
  • Acts as a resource / subject matter expert for UC Health Patient Financial Services and Revenue Cycle departments.
  • Assists in the evaluation for system hardware and software products.
  • Provide access to multiple applications and payer online software.
  • Utilize Service Request system for documentation of requests and recording resolution.
  • Utilize designed methods for monitoring, maintaining, and terminating user access.
  • Provide audit documentation of user security as required
  • Defines and designs system tables, parameters and set up that optimizes application functionality.
  • Effectively interacts with vendors, UC Health IS&T, and end users to evaluate and implement products.
  • Provides information and designs for testing applications and contingency plans.
  • Provides timeline for all non-project enhancements.
  • Develops accurate application functional and technical specifications.
  • Design ad-hoc reports to meet customer requests.
  • Utilize report-scheduling software to automate reporting where applicable.
  • Provides maintenance support for all application tables or reports.
  • Checks, verifies, and processes standard application reports as required by end users.
  • Facilitates end user meetings.
  • Develops consensus within user groups.
  • Encourages and displays actions that result in high client satisfaction or process improvements.
  • Provides effective written and verbal communication to end users.
  • Provides consults to end users.
  • Assisting in the implementation of new third-party systems that support the Revenue Cycle:
  • Assesses and escalates user requests and issues.
  • Assists with vendor and consultant activities.
  • Facilitates installation of new applications, application upgrades and patches.
  • Works with programming teams on application development.
  • Provides consults to IT staff.
  • Provides training and assistance to PFS/Rev Cycle staff on new and or upgraded applications.
  • Provides task level detail for project plans, including suggested schedules and skill set of team members required
  • Provides accurate and timely status reports.
  • Documents and ensures timely resolution of project issues.
  • Coordinates effectively with team members and vendors.
  • Determines and manages workload priorities.
  • Raises issues to the appropriate level resource to projects.
  • Other duties as assigned
  • Provides occasional backup for other application analysts
  • Dictation for Physician Advisor
  • Peer to peer follow up
  • Schedule for physicians


Qualifications

  • Minimum Required: High School Diploma or GED.
  • Preferred Degree: Associate's Degree - Info Systems or similar.
  • Epic Hospital Billing and/or Epic Clarity Data Model (or current Epic equivalent) certification preferred within one year.
  • Minimum Required: Willing to certify, license or graduate within 12 months. 1 - 2 Years equivalent experience.
  • Preferred: 3 - 5 Years equivalent experience.