About the job

Line of Service

 

Advisory

 

Industry/Sector

 

Not Applicable

 

Specialism

 

Managed Services

 

Management Level

 

Senior Associate

 

Job Description & Summary

 

A career in our Advisory Acceleration Centre is the natural extension of PwC’s leading class global delivery capabilities. We provide premium, cost effective, high quality services that support process quality and delivery capability in support for client engagements

 

To really stand out and make us fit for the future in a constantly changing world, each and every one of us at PwC needs to be an authentic and inclusive leader, at all grades/levels and in all lines of service. To help us achieve this we have the PwC Professional; our global leadership development framework. It gives us a single set of expectations across our lines, geographies and career paths, and provides transparency on the skills we need as individuals to be successful and progress in our careers, now and in the future.

 

The primary purpose of this position is to perform account research and analysis to validate accuracy, completeness and appropriateness of actions taken to resolve accounts in adherence to client, organization, regulatory policies and procedures. The Account Analyst takes direction from the Team Lead and provides support for special projects, quality control, and account resolution.

 

Years Of Experience

 

Minimum 3+ years is required in the following areas:

 

• Medical collections (Medical Collections Specialist II preferred), billing and/or claims experience
• Customer service experience
• All payer knowledge required (government and non-government)

 

Responsibilities

 

The Account Analyst specific responsibilities include but are not limited to:

 

• Mentors/coaches all staff members to be proficient in client patient accounting system, including, but not limited to: counseling low performers; providing training opportunities to improve quality of work and/or to address an individual’s ongoing developmental goals; and answering questions and concerns from staff;
• Consults with Continuous Improvement Specialist to identify and assess training needs associated with changes in policies, procedure regulations, business initiatives and technologies;
• Provides new-hire training on general billing and follow-up processes; system training; healthcare payer processes; engagement-specific policies; and organization-specific processes;
• Suggests performance improvement measures and evaluates their effectiveness against predetermined objectives;
• Monitors team performance and success against pre-defined key performance indicators (i.e. productivity, quality, etc.);
• Executes the development and preparation of job aids, instructional materials, classroom, and online training appropriate to specific objectives; and,
• Makes recommendations to improve client service based upon training observations.

 

Required Knowledge And Skills

 

• Demonstrated ability exceeding all established department/client quality and productivity standards;
• Proven ability to lead by example and foster mentoring relationships;
• Strong written and oral communication skills;
• Computer and internet literate in an MS Office environment;
• Ability to establish and maintain effective working relationships;
• Possesses ability to professionally communicate (in all forms) with payer and client resources such as: on-site visits, website, e-mail, telephone, customer service departments, etc.;
• Exemplifies extensive knowledge of the hospital revenue cycle with specialization in hospital billing, follow-up, and the account resolution process to include, but not limited to: claims submission, acceptance, and adjudication, transaction reviews, adjustment posting, identification of patient responsibility, etc.;
• Possesses considerable leadership skills, fostering an atmosphere of trust; seeks diverse views to encourage improvement and innovation; coaches and develops staff through timely and meaningful written and verbal feedback; and,
• Possesses a cooperative and positive attitude toward clients, management and co-workers by responding politely and professionally and being a valued team player.
• US Healthcare Commercial and Managed Care Insurance Claim Management/Billing/Claim Edit Resolution
• US Healthcare Medicare and Medicaid Insurance Claim Management/Billing/Claim Edit Resolution
• US Healthcare Denials Management (technical and clinical)
• US Healthcare Underpayment/Payment Variance Management

 

Desired Knowledge / Skills

 

• Training on Medical Billing process
• AR and Denial Management
• New-hire training on general billing, the hospital revenue cycle, medical collections, billing and/or claims
• Epic Resolute, HB and PB Patient Accounting
• Cerner RevElate Patient Accounting
• Meditech Patient Accounting

 

Education (if blank, degree and/or field of study not specified)

 

Degrees/Field Of Study Required

 

Degrees/Field of Study preferred:

 

Certifications (if blank, certifications not specified)

 

Required Skills

 

Optional Skills

 

Desired Languages (If blank, desired languages not specified)

 

Travel Requirements

 

Not Specified

 

Available for Work Visa Sponsorship?

 

No

 

Government Clearance Required?