Quality Analyst, Patient Access Services

FLSA Status

Non-exempt

Job Role Summary

The Quality Analyst with Patient Access Services, under the supervision of the Patient Access Quality and Education Supervisor and Patient Access Services Operations Manager, will maintain Standard Operational Procedures and dashboard analytics. This includes the responsibility to pull, maintain, monitor, the data metrics for Patient Access Services. Other tasks include participating in program development, building Standard Operating Procedures, and reporting on data analytics, as well as objective competencies. Quality Analysts attend various meetings, continue learning, and troubleshoot system issues. This role exists to provide data reporting, process improvement, as well as systems and process knowledge.

Essential Functions and Responsibilities

• Collects, enters, and analyzes quality and performance data; generates reports and makes recommendations for future improvement based on analysis
• Evaluates and identifies trends with the quality of information input into Epic during the processes of scheduling, pre-registration, registration, and check-out in addition to financial clearance
• Provides ongoing feedback to managers, supervisors and staff on continuous process improvement
• Identifies areas of focus, issues, and trends to make improvements to overall denial rate for front end related denials
• Assesses and reports to leadership metrics for eligibility related denials including escalating issues as appropriate
• Prepare and present project information at internal and external meetings as directed
• Responsible for development and standardization of Standard Operating Procedures (SOPs) as directed
• Respond to the department needs by accepting additional assignments that may or may not be related to the job's primary responsibilities to ensure the continuity of department services
• Screen and prioritize all requests and provide prompt, courteous, professional, and accurate information in all communications
• Demonstrate professionalism by establishing and maintaining effective working relationships with directors, managers, co-workers, other departments’ staff, and customers.
• Extracts and compiles data from regulatory agency sources and internal data sources and compares to benchmarks and standards for clinical, operational, and financial measures in order to give a clear picture of performance
• Acts as a resource in the use of database applications, presentation software, and dashboards
• Builds audit tools for quality and performance improvement
   

Job Requirements

Accredited Bachelor’s degree in Health Services or a related field and/or four (4) years of experience in registration, insurance eligibility, benefit verification, hospital billing (HB) or physician’s billing (PB) required.

Knowledge, Skills & Abilities

• Possesses an understanding of Patient Access Services and Epic end-users’ workflows
• Excellent verbal and written communication skills
• Experience with personal computers and office equipment required
• Working knowledge in Microsoft Excel, Word, PowerPoint and basic training software required
• Working knowledge of patient scheduling, registration requirements of Medicare, Medicaid, and commercial insurance companies, and basic revenue cycle operations