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Kaiser Permanente Revenue Management Recovery Analyst in Portland, Oregon

Revenue Management Recovery team will design and deploy strategic delivery arm of revenue cycle that will deliver the changes, Team assembled to perform root cause analysis and remediation to investigate issues in accounts and identify solutions and collaborate with regions and KPHC for ongoing corrections Revenue Management recovery processes, including, delinquency management, internal collections and third party payer management. To manage the quality and timeliness of billing and recovery. To gain valuable insight into the group recovery risks in the group and identify, educate and collaborate with all Regions to close the loop on the root issues creating the underpayments. This Department leverages both transaction level information as well as powerful financial analytics to professionally collect monies owed Kaiser Permanente. The Revenue Management Recovery department continually seeks to gain a higher level of financial transparency to identify, analyze, correct and recover payments on grossly underpaid claims that are currently written off to contractual adjustment. Critical management reporting functions include: be the safety net for all regions as unplanned issues cause, Accounts Receivables to go unbilled or worked and balances are unnecessarily written off continuous account monitoring, predicting bad debt exposure, proactive risk analysis, payment terms analysis. The Revenue Management Recovery department is responsible for providing consultative leadership in; establishing and maintaining strong internal controls over billing processes and root cause analysis of recovery concerns.

Essential Responsibilities:

  • Investigates and does root cause analysis of billing processes on closed or claims considered lost to identify and pursue recovery. Prepares written monthly and quarterly reports summarizing the activities of the various segments.

  • Investigate issues and complete special projects as designated by the Manager.

  • Corrects and Re-submits bills for unpaid claims.

  • Review financial reports for accuracy.

  • Provide analysis of various accounts.

  • Recommend methods and procedures to improve the functioning of Revenue Management.

Basic Qualifications:

Experience

  • Minimum three (3) years directly related experience in credit collections, revenue management, healthcare insurance billing or similar field required.

Education

  • Associate's degree in Finance and Accounting, Business Administration, or a related field, OR two (2) years directly related experience required.

  • High School Diploma or (General Educational Development (GED) required.

License, Certification, Registration

  • N/A.

Additional Requirements:

  • Excellent spreadsheet (Excel), word processing (Word), and database skills.

  • Excellent written and verbal communication and presentation skills.

  • Understanding of revenue cycle, change control, root cause analysis.

  • Knowledge of healthcare revenue capture and documentation guidelines.

  • Skilled at researching and translating Federal, State and Insurance Company regulations to compliant billing requirements.

  • Healthcare Insurance Industry knowledge.

  • Working knowledge of revenue management internal controls, and accounting procedures.

  • Knowledge and ability to translate data into accurate financial and management reports.

  • Aptitude for numbers.

  • Strong attention to detail and well organized.

  • Must be able to work in Labor/Management Partnership environment.

Preferred Qualifications:

  • Experience with claims research and analysis of denied and unpaid claims

  • Issue resolution

Kaiser Permanente is an equal opportunity employer committed to a diverse and inclusive workforce. Applicants will receive consideration for employment without regard to race, color, religion, sex (including pregnancy), age, sexual orientation, national origin, marital status, parental status, ancestry, disability, gender identity, veteran status, genetic information, other distinguishing characteristics of diversity and inclusion, or any other protected status.

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with federal and state laws, as well as applicable local ordinances, including but not limited to the San Francisco and Los Angeles Fair Chance Ordinances.

COMPANY: KAISER

TITLE: Revenue Management Recovery Analyst

LOCATION: Portland, Oregon

REQNUMBER: 892006

External hires must pass a background check/drug screen. Qualified applicants with arrest and/or conviction records will be considered for employment in a manner consistent with Federal, state and local laws, including but not limited to the San Francisco Fair Chance Ordinance. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, national origin, sexual orientation, gender identity, protected veteran, or disability status.

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