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.
The Hospital Billing and Follow-Up Analyst is responsible for managing and optimizing the billing, reimbursement, and follow-up processes for government payers such as Medicare, Medicaid, and other state and federal programs. This role includes advanced data mining, trend analysis, and reporting to identify payment issues, delays, or underpayments. The analyst works collaboratively with the Government Manager and internal departments to improve revenue recovery and payer compliance.
Responsibilities
Perform end-to-end government payer billing and follow-up activities to ensure timely and accurate reimbursement.
Use data mining tools (e.g., Slicer Dicer, Excel, Tableau, or other reporting software) to extract and analyze large data sets related to billing and payment performance.
Identify trends and root causes of denials, payment delays, and underpayments from government payers.
Develop dashboards, reports, and metrics to monitor claims status, aging accounts, and payer performance.
Conduct account reviews to resolve rejections and denials.
Collaborate with billing, coding, registration, and clinical departments to address systemic issues affecting claims.
Ensure compliance with CMS (Centers for Medicare & Medicaid Services) billing guidelines and regulations and report on upcoming CMS changes
Provide regular updates and presentations to leadership on performance trends and recommendations for process improvements.
Support audits and assist in documentation requests from government agencies or internal compliance.
Qualifications
Minimum Required: High School Diploma or GED. | LICENSE & CERTIFICATION: None Required | Preferred: 3 - 5 Years equivalent experience. Prior experience in data mining, healthcare analytics, or revenue cycle analysis is highly desirable
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