Estimates and Financial Assistance System Analyst / Revenue Cycle

Job Title

Estimates and Financial Assistance System Analyst

Job Description

Schedule: Monday - Friday, 8:00am to 4:30pm. In office position.

At Children's, the region's only full-service pediatric healthcare center, our people make us the very best for kids. Come cultivate your passion, purpose and professional development in an environment of excellence and inclusion, where team members are supported and deeply valued. Opportunities for career growth abound as we grow our services and spaces, including the cutting-edge Hubbard Center for Children. Join our highly engaged, caring teamand join us in providing brighter, healthier tomorrows for the children we serve. Children's is committed to diversity and inclusion. We are an equal opportunity employer including veterans and people with disabilities.

A Brief Overview The Estimates and Financial Assistance System Analyst is responsible for collaborating with Revenue Cycle Division Leaders, Clinical and Information Systems stakeholders, and Compliance to ensure all Federal, State, and local government requirements are met. This position helps ensure the organization adheres to Price Transparency regulations including the No Surprise Billing Act (NSA) and serves as the primary resource to ensure regulations for the shoppable services, consumer estimate templates, and financial assistance programs are accurately defined, maintained, and built within Epic.

Essential Functions

• Ensure Children's shoppable services and estimate templates comply with government regulations.
• Develop a clear understanding of Children's charge masters, services provided, pricing methodologies, and financial assistance program policies.
• Collaborate with Revenue Cycle stakeholders to ensure CPT coding, pricing, and reimbursement align with clinical locations and services.
• Build, maintain, modify, and update templates and rules for shoppable services, estimates, and financial assistance module configurations, particularly when CPT codes, services, payer and/or regulatory requirements, or organizational policies change
• Conduct audits of estimates to ensure accuracy and compliance with established standards and regulatory requirements
• Act as the Revenue Cycle expert to ensure Epic system build meets all Federal, State, and local requirements for Price Transparency and 501R regulations.
• Maintain a comprehensive understanding of Epic functionality, consumer pricing, estimates, and financial assistance workflows to identify, evaluate, and implement system enhancements that optimize functionality.
• Ensure Epic system build supports all required formats, specifications, and workflows for consumer estimates and financial assistance programs, serving as the Revenue Cycle liaison for projects that impact estimate and financial assistance build and functionality.
• Ensure the continued functionality and accuracy of estimate and financial assistance program workflows following system upgrades. Evaluate and integrate new system features and enhancements into existing estimation and financial assistance processes to support operational efficiency and compliance.
• Collaborate with IT, Finance, Patient Access, Revenue Cycle, Compliance, and key clinical leaders to create or modify consumer pricing, estimate, and financial assistance workflows and system build requirements.
• Provide clear communication and education to key areas regarding pricing processes and updates.
• Review and post NSA adjustments when necessary. Serve as backup support for Good Faith Estimates (GFEs) creation and processing to ensure timely and accurate patient cost estimates.
• Participant in Children's Nebraska meetings and external webinars related to price transparency.
• Maintain knowledge through government and payer communications
• Keep abreast of Federal, State, and Local government requirements.
• Other duties as assigned.

Education Qualifications

• Bachelor's Degree from an accredited college or university in healthcare administration, information systems, business or related field or equivalent work experience. Required or
• Equivalent relevant work experience may be substituted for education Required

Experience Qualifications

• Minimum 3 years' experience in healthcare revenue cycle Required and
• Minimum 1 year experience in healthcare price transparency to include shoppable services or consumer estimates Preferred and
• Minimum 1 year of Epic experience in revenue cycle Preferred

Skills and Abilities

• Knowledge of hospital billing, collection and reimbursement requirements and standard practices preferred.
• Knowledge of the current healthcare climate; including managed care developments, HIPAA standards and governmental program regulations preferred.
• Knowledge of CPT, HCPCS and revenue codes and their effect on hospital/professional reimbursement preferred.
• Knowledge of compliance regulations as they relate to price transparency requirements.
• Adept analytical skills, and a proven ability to develop effective solutions for complex business challenges
• Ability to communicate effectively both verbally and in writing.

Licenses and Certifications

• Must obtain Epic certification in Resolute Hospital Billing Charging or equivalent job-related certification and maintain the certification(s) for duration of employment in Revenue Cycle within 1 Year Required

Children's is the very best for kids and the very best for your career! At Children's, we put YOU first so together, we can improve the life of every child!