UW Medicine’s mission is to improve the health of the public by advancing medical knowledge, providing outstanding primary and specialty care to the people of the region, and preparing tomorrow’s physicians, scientists and other health professionals.
The BUSINESS OPERATIONS SYSTEMS ANALYST - PATIENT ACCESS is both a technical and operational subject matter expert on Patient Access functions and systems with sole responsibility for Authorization Determination and insurance rule management collaboration collected at time of order, schedule and check-in via Authorization Management, a tool used throughout the Revenue Cycle. The incumbent proactively identifies operational processes and technical system enhancement opportunities to assist Revenue Cycle leadership in the coordination of complex projects that promote operational efficiencies, reduce denials, enhance system functionality
ANALYZE BUSINESS PROCESSES AND PROCEDURES
Evaluate, recommend, build and deploy technical solutions and improvements based off of payer guidelines, authorization requirements, governmental regulations and organization policy across revenue cycle to improve productivity, create efficient workflows and reduce denials.
Act as an expert resource to UW Medicine staff by anticipating and identifying system changes, developing and deploying payer rule build, creating educational and procedural documentation procedural to meet functional problems associated with the revenue cycle system applications and cross-system interfaces
Research, analyze, develop and deploy workflow to meet business operational needs for front end registration meeting authorization requirements in collaboration across revenue cycle.
Evaluate solutions and system products that enhance the quality, track data compliance, improve productivity within patient access to support claim-related functionality.
Document requirements and develop reports to support all metrics for all areas impacted by payer policy authorization requirements across the revenue cycle.
ENSURE INPUT DATA ARE HIGHEST QUALITY NECESSARY TO PRODUCE CLEAN CLAIMS AND REDUCE DENIALS
Proactively monitor applications and tools used by front end processing for compliance, billing, and regulatory requirements.
Provide support by working directly with end users to assist in resolution of application and process problems.
Work closely with the UW Medicine IT Analysts to provide efficient and responsive collaboration of technical enhancements and project implementations
Provide supportive and positive mechanisms for reporting application and system deficiencies, and facilitate reporting of suggestions for system improvements.
Using quality improvement principles, monitor system impact on user and departmental workflows and incorporate results into system enhancements.
DEFINE AND DOCUMENT CUSTOMER REQUIREMENTS
Act as technical quality assurance liaison and business operational subject matter expert between application system end users, revenue cycle leadership, training resources and system vendors and developers.
Act as a liaison and/or facilitate communication between end users and IT System administrators, other analysts and programmers.
Participate in leading work with user groups to provide diagnostic assistance, resolution to questions, and problem direction.
Maintain clear and consistent communication with all levels of user groups regarding changes to systems.
PROACTIVELY REVIEW, EVALUATE, MONITOR AND MAINTAIN SYSTEM FUNCTIONALITY
Work with all required (intradepartmental & interdepartmental) personnel to define and manage changes to systems, tools and/or functional workflows.
Maintain all technical documentation for assigned system(s) and tools used across revenue cycle
Perform analysis and troubleshooting of issues for assigned system(s) and tools.
Provide regular status to management, customers, and stakeholders.
DEVELOP AND MAINTAIN TECHNICAL DOCUMENTATION
Identify and report patterns of system and revenue cycle business requirement non-compliance.
Summarize patterns and issues arising from front end encounters creation for procedure based scenarios to capture and reduce denials.
Develop technical documentation for assigned applications/systems and tools including proposed data flows.
Assist with and document the development of new standard operational procedures using information technology methodology.
PROVIDE REGULAR STATUS REPORTING UPDATES Provide weekly status reports on progress to revenue cycle leadership. Information should be accurate timely, and pertinent.
OTHER DUTIES, AS ASSIGNED
Act as backup for other team members and functions, as needed
Participates in and leads design and implementation groups, including managing small to medium projects.
Provides status reports to leadership as required Coordinates team efforts to plan, design and develop technical system requirements and implementation of assigned applications/systems and tools and subsequent upgrades and enhancements.
Bachelor’s Degree in Healthcare Administration, Business or related area
At least four (4) years in Patient Access positions as a lead or other similar position where analysis and problem solving skills have been demonstrated.
Expert working knowledge of Epic ADT, Prelude, Cadence/Scheduling, hospital billing systems, and other hardware and software systems related to Patient Access.
Epic certification in one or more area of the Revenue Cycle. Clinical background preferred
Equivalent Education and Experience may substitute for requirements
Extensive experience in project planning, system and workflow analysis, technical methodology, documentation development, implementation, and business operation workflows and documentation.
Healthcare environment experience working with HL7, SQL, HIPPA, ABN-EEN, CPT-HCPC, CAP, JACHO, MQSA and other healthcare related regulation. Proficient in data design, database structure, interface mapping, data communication protocols and standard.
Proficiency in the use of applications, including, but not limited to:
MS Software, Office Suite with emphasis in Visio, Project, Access, and PowerPoint, Graphic Software, Adobe Publisher, Epic, Clinical orders knowledge preferred
Cerner application knowledge desired
Proficient understanding of network environments, including servers, databases, clients and interfaces.
Proficient in deployment and support of standard business hardware and tools
CONDITIONS OF EMPLOYMENT
Fast-paced professional office environment
Normal working hours. May also work off hours and weekends.
On-Call coverage (7x24), as assigned.
Must have personal transportation for quick access to multiple sites, including both medical centers and IT Services.
UW Medicine is committed to being a drug-free workplace. We require a pre-employment drug screen. The use of marijuana for medical purposes accompanied by a prescription, even if permitted by state law, will not be considered acceptable for purposes of explaining a positive lab test result for marijuana.
UW Medicine includes Harborview Medical Center, UW Medical Center - Montlake, UW Medical Center - Northwest, Valley Medical Center, UW Neighborhood Clinics, UW Physicians, UW School of Medicine, and Airlift Northwest.
Founded in 1861, the University of Washington is one of the oldest public institutions in the west coast and one of the preeminent research universities in the world. The University of Washington is a multi-campus university comprised of three different campuses: Seattle, Tacoma, and Bothell. The Seattle campus is made up of sixteen schools and colleges that serve students ranging from an undergraduate level to a doctoral level. The university is home to world-class libraries, arts, music, drama, and sports, as well as the highest quality medical care in Washington State and a world-class academic medical center. The teaching and research of the University’s many professional schools provide undergraduate and graduate students the education necessary toward achieving an excellence that will serve the state, the region, and the nation. As part of a large and diverse community, the University of Washington serves more students than any other institution in the Northwest.