Children's National Health System

Senior Business Operations Analyst (39184702)
Location: Washington, District of Columbia - United States
Posted: 11/20/2017

Senior Business Operations Analyst

Position Summary
Responsible for research and reporting of data related to reimbursement reductions, delays, and non-payment. Serve as the primary liaison between department leadership and/or physicians and the revenue cycle. Meet with department leadership and/or physicians to present data, root cause and develop action plans. Responsible for ensuring solutions implemented and goals achieved. Reports PI initiatives & results. Monitor/identify CMS & payor rule changes & key stakeholders to ensure compliance. Serve as the primary support to Reimbursement & Collection Manager and VP of Revenue Cycle.

Minimum Education

Bachelor's Degree

Minimum Work Experience
5 years

Specific Requirements and Preferences
At least 5 years of related patient accounting experience required, especially related to denial mitigation, root cause analysis and/or Physician Liaison. Experience in developing and presenting data supported analysis findings to key stakeholders required. Previous experience in health care is highly desirable, including experience with hospital/physician information and patient accounting information systems.

Required Skills/Knowledge
Proven analytical skills including ability to make recommendations based on financial analyses. Excellent PC skills including advanced skill proficiency in Access and Excel spreadsheet analysis. Ability to work in a team environment with other analysts, managers, and physicians. Proficiency in presentation of analytical results. Excellent working knowledge of coding & NCCI edits. Demonstrated knowledge of managed care payer requirements in an acute/physician setting. Demonstrated ability to facilitate team or group activities. Excellent verbal and written communication skills. Demonstrated ability to be flexible and to prioritize workload & decision-making skills. Ability to train clinical staff on new technologies and processes, and to analyze workflow for process improvement. Strong organizational and coordination skills required.

Functional Accountabilities
Liaison and Support for Stakeholders
Appropriately engage and involve key accountable stakeholders in a collaborative manner.
Serve as primary support for Reimbursement & Billing Manager for denial workgroup; provide presentation & findings.
Research payer & CMS policies related to revenue cycle; identify & stakeholders of required changes; track and ensure completions.
Data Analysis and Issue Resolution
Manage matrix of issues & resolutions including accountable stakeholders; ensure results and escalate issues as appropriate; regularly report updates and challenges to manager.
Conduct root cause analysis of issues reducing reimbursement & slowing payment cycle. Identify key issues and assist in tracking, trending and reporting.
Present data and analysis, clearly, to all levels of staff, management &/or physicians.
Meet with department leadership &/or physicians to review issues and develop action plans.
Assist in development of solutions, training & education to resolve issues and share data with staff and management.
Assist with appeal submission and follow up when necessary to ensure deadlines are met; ensure maximum recovery of reduced reimbursement.
Performance Improvement
Understand managed care contracting & reimbursement schemes (Prof /Tech) as well as payer requirements, reimbursement policies & clinical policy bulletins and apply principles to improve performance.
Apply CMS reimbursement rules to operation to drive improved performance.
Develop knowledge of internal billing systems & edits and make recommendations to mitigate denials.
Develop detailed knowledge of internal billing coding and CDM process to identify breakdowns and resolutions.

Staff Competencies
Organizational Commitment/Identification Partner in the mission and upholds the core principles of the organization
Committed to diversity and recognizes value of cultural/ ethnic differences
Demonstrate personal and professional integrity
Maintain confidentiality at all times
Customer Service Anticipate and responds to customer needs; follows up until needs are met
Teamwork/Communication Demonstrate collaborative and respectful behavior
Partner with all team members to achieve goals
Receptive to others' ideas and opinions
Performance Improvement/Problem-solving Contribute to a positive work environment
Demonstrate flexibility and willingness to change
Identify opportunities to improve clinical and administrative processes
Make appropriate decisions, using sound judgment
Cost Management/Financial Responsibility Use resources efficiently
Search for less costly ways of doing things
Safety Speak up when team members appear to exhibit unsafe behavior or performance
Continuously validate and verify information needed for decision making or documentation
Stop in the face of uncertainty and takes time to resolve the situation
Demonstrate accurate, clear and timely verbal and written communication
Actively promote safety for patients, families, visitors and co-workers
Attend carefully to important details - practicing Stop, Think, Act and Review in order to self-check behavior and performance


See Above

Primary Location: Maryland-Silver Spring

Work Locations: Dorchester 12200 Plum Orchard Dr Silver Spring 20904
Job: Non-Clinical Professional
Organization: Finance
Regular / Temporary: T (Temporary)
Position Status: FT - Full-Time
Shift: Day
Work Schedule: Mon - Fri

Additional Requirments / Information

Job Capacity:Employee (full-time)
Minimum Education Level:See Job Description
Visa Sponsorship: No
Related Industries:Other

At Children's, we know what it takes to really connect with kids, we're looking for nurses who love a challenge.

Pediatric nurses have to be patient. They have to be understanding, yet able to communicate effectively and honestly with a child and their family about their illness and treatment. And every Children's nurse must have the confidence to take a patient's care into his or her own hands.

At Children's you'll work closely with each patient and their family across a continuum of care - beginning with admission, when you perform physical assessments and take a patient/family history that covers all the vitals.

You'll prepare and carry out a plan of patient care. You'll work with professionals from all Children's health care disciplines. Together you will ensure your patients' progress every step of the way. You will even make rounds with physicians, discussing your patients' conditions and needs.

Professionally, you'll grow like never before.

The nursing practice environment at Children's is ideal for developing your skills to the maximum, increasing your level of responsibility and entering new specialty areas.

Our versatile career ladder, the Program for Professional Advancement (PPA), enables you to move both vertically and laterally across a wide range of clinical, educational and management opportunities. Recently we restructured our nurses compensation package to include:

  • Flexible Scheduling

  • Tuition Assistance

  • Professional Development

  • Clinical Ladder

  • Continuing Education Conferences (local, regional, national)

  • Weekend Incentive Program

  • Exceptional Differentials

  • Preceptorship and Charge Nurse Recognition

  • Certification and Degree Recognition Bonus

  • Collaborate with Internationally-Acclaimed

  • Medical Leaders

  • Pediatric Nursing Fellowships (PICU, NICU, Hematology/Oncology)


Our recent achievement of Magnet status reflects what we’ve known all along: That our nurses are something very special - that their vision, talents, dedication and leadership define a truly exceptional practice environment. We invite you to learn more about our Magnet environment, accomplished by approximately 6% of the nation’s hospitals, and even fewer pediatric centers.

We are also a Beacon Award winner, recognized for our outstanding CICU and PICU environments. In fact, our Pediatric Cardiac Intensive Care Unit is the first in the country to be designated a Beacon Award winner AND our Pediatric Intensive Care Unit is the first in the Northeast region to receive the Beacon designation!

*Children's National Health System has requested along with applying online at you also fill out additional information on their site. Please click 'Apply Online' to begin the application process.

* If you would like to find out more about this position or this particular hospital, please click on the 'Information' button. We realize that you may need further information even if you are not ready to apply for a job at this time.

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