Project Policy Analyst 4

%

of time

Essential Function (Yes/No)

Key Responsibilities

(To be completed by Supervisor)

55

Analyzes highly-complex financial data and identifies trends in revenue cycle functions and integration of operations. Delivers comprehensive reports and presentations to leadership, to include proposals and solutions to maximize revenues.

Develops dashboards and processes for continuous management and analysis of revenue cycle functions. Develops and proposes new or changing components of the revenue integrity program, to maximize revenues and increase efficiencies.

Leads and / or monitors progress and priorities on projects. Collaborates with departments across the system to assimilate and define needs, develop goals and metrics, and define system requirements and capabilities.

1. Performs data analysis and report generation specific to revenue cycle operations and functions.

2. Able to perform special studies/projects complex in scope, which require independent development of innovated analytical approaches to resolve issues related to financial management, revenue cycle process, IT systems and/or other automated systems. Key emphasis is patient liability policy review and revision and development of education, training, guidelines, communication and scripting of self-pay discount policies and procedures.

3. Works directly with revenue cycle owners and unit managers in the building of report data, data validation and report production.

4. Prepares written status reports for Revenue Cycle Quality and Education leadership on project progress, next steps, time frames and other requested topics.

5. Effectively communicates with revenue cycle leaders, managers, super users and other key constituents.

6. Develops and effectively documents standards, policies and control requirements in collaboration with director.

7. Supports the production and reporting of key revenue cycle measures, benchmarks and analytics that will promote overall revenue cycle efficiency, operational and financial optimization, and the patient experience.

8. Performs other duties as assigned by Management.

Specifically:

• Supports and develops and co-develops with APeX training and operator teams staff training in response to defined training curriculum and delivery modes. Delivers training methods and curriculum and monitors training compliance where appropriate.
• Working with director, drafts system and policy changes and standardized communications.

In partnership with colleagues in operations and APeX, this position, provides analysis, scrutiny and assessment of workflow, work queues and process in the following areas:

• Patient Access Services

  • Admissions and Financial Counseling (Central Admitting and Transfer Center)

  • Registration (Inpatient, Ambulatory, ED, L&D, Home Health, etc.)

  • Cadence Scheduling

  • Referral Management

• Pre-Service, Access and CAU, and CCS Auth Units

• Patient Financial Services

  • Billing

  • SBO

  • Account Follow-up and Denial Management

  • Cash Application

  • Customer Service

The position routinely works with the following areas:

• Revenue Management/Revenue Integrity

• Patient Access Services managers and staff

• Revenue Cycle Patient Access Super Users

• Professional Billing (MGBS) – in particular, Client Service Managers

• Hospital Billing Services (Patient Access and PFS)

• Ambulatory managers and super users

• Clinical Services managers and super users

• Faculty Practice administration

• APeX configuration, reporting, and training teams

All the above processes and procedures must be completed in accordance with the HIPAA mandated rules, regulations and requirements and in accordance with UCSF Medical Center and PFS Department policies.

20

Process Improvement

• Serves as a technical leader and resource in evaluating revenue cycle workflows to propose improvements in efficiencies and timeliness. Provides guidance and expertise in the development of highly-complex workflow improvements to integrate practices.
• Develops and implements changes to systems, policies and procedures to maintain currency in government regulations, reimbursement issues and other matters having potential financial impact.
• Recommends and implements new processes and systems to improve charge integrity, reconciliation and charge linkages from ancillary charging systems for the medical center / health system.
• Recommends and designs structured workflow improvements.
• Identifies opportunities for revenue cycle rapid cycle improvement; participates in LEAN programs

25

Quality and Education

• Develops and delivers training to patient financial services units on revenue cycle systems, processes and procedures. Patient finance areas include registration, insurance verification, financial counseling and authorization processes.

• Contributes to the Design of processes to achieve high level of data capture and transactional accuracy and quality throughout the revenue cycle

• Works with operators and training departments to help define, develop, organize, and implement training programs for employee development and on-the-job training across all applicable departments.

• In collaboration with director, develops departmental training and cross training for staff and clinicians across the medical center revenue cycle. Partners with the Clinical Services departments, HODs, and ambulatory practices in utilizing administrative and quality data to target training needs in the areas of scheduling, pre-registration, registration, insurance verification, authorization, financial clearance, cashiering, compliance, revenue cycle overview, and other revenue cycle functions as required.

• Supports the design and implementation of revenue cycle quality improvement systems, metrics, dashboards, reports, and methodologies.

• Works with teams to define and refine quality measurements, benchmarks, and employee expectations.

• Conducts performance audits on scheduled and unscheduled intervals analyzing data, observing processes and shadowing job activities to identify workflow optimization opportunities. Identifies and collaborates toward report development, proper distribution and usage of reports.

100%