Miami Valley Hospital

Analyst

• Serve as the primary point of contact for Revenue Cycle Epic-related issues, enhancements, and improvement opportunities.
• Submit and manage Epic support tickets and enhancement requests with the Digital Health & Technology (DHT) team, tracking progress and communicating updates to stakeholders.
• Collaborate with operational leaders and end-users to identify gaps in workflows and recommend Epic system solutions.
• Lead or support projects involving Epic system configuration, testing, validation, and go-live implementation.
• Monitor and analyze system performance and data trends to ensure optimal functionality and identify areas for improvement.
• Stay informed on Epic upgrades, new functionality, and best practices; assess their potential impact on Revenue Cycle operations.
• Participate in governance processes related to Epic system changes and change control.
• Develop and maintain documentation related to workflows, configurations, and system enhancements.
• Provide education or training to operational teams regarding system changes or new functionalities.
• Partner with IT, compliance, finance, clinical teams, and other stakeholders to ensure alignment and system integrity.

Revenue Cycle & Systems Analyst

Nurse

• Work remotely from a centralized location
• Partner with bedside nurses and advocate for patients/families/significant others
• Provide physical, emotional, and spiritual support
• Collaborate with, and guide care delivered by the inter-professional team
• Perform tasks that may include admissions, discharges, patient education, rounding on patients, performance improvement, etc.
• Accountable for compliance with the Ohio Nurse Practice Act, Nursing Code of Ethics, and applicable regulatory standards

Virtual Nurse – RN

• 24/7 accountability for leadership, operational management, and clinical oversight of a team of virtual nurses and unlicensed caregivers
• Ensures successful integration of virtual nursing services into the care delivery model
• Optimizes patient outcomes, caregiver experience, quality, safety, and operational efficiency
• Collaborates with nursing operations, clinical informatics, digital health and technology, physicians, and advanced practice providers

Nurse Manager – Virtual Care Integration

Manager

• Oversees daily operations within the PPN Central Billing Office as it relates to the scope and responsibilities of your assigned team.
• Works with the CBO Administrator to develop, implement, and maintain efficient and effective workflows to ensure revenue/cash optimization and to limit risks associated with coding and billing practices.
• Assists in providing direction, instruction, and guidance to all members of the PPN CBO team for the purpose of training and staff development.
• Works with PPN Practice Managers, providers, and staff, to develop process improvements needed to maintain optimal performance and productivity within the team.
• Performs all functions with a high level of discretion, integrity, and professionalism.
• Provides guidance and direction using independent analysis and conclusion that aligns with leadership direction and the Premier Health mission.
• Develops and maintains good relationships with employees, peers, PPN staff, and leaders, to ensure our customers receive the level of service necessary to build confidence and trust in the network and for our providers.
• Effective recruitment, development, and management of team members is an essential requirement of the CBO A/R Manager role.

Manager, CBO A/R

• Serve as the primary point of contact for Revenue Cycle Epic-related issues, enhancements, and improvement opportunities
• Submit and manage Epic support tickets and enhancement requests with the Digital Health & Technology (DHT) team, tracking progress and communicating updates to stakeholders
• Collaborate with operational leaders and end-users to identify gaps in workflows and recommend Epic system solutions
• Lead or support projects involving Epic system configuration, testing, validation, and go-live implementation
• Monitor and analyze system performance and data trends to ensure optimal functionality and identify areas for improvement
• Stay informed on Epic upgrades, new functionality, and best practices; assess their potential impact on Revenue Cycle operations
• Participate in governance processes related to Epic system changes and change control
• Develop and maintain documentation related to workflows, configurations, and system enhancements
• Provide education or training to operational teams regarding system changes or new functionalities
• Partner with IT, compliance, finance, clinical teams, and other stakeholders to ensure alignment and system integrity.

Epic Revenue Cycle & Systems Analyst

Medical Billing and Coding

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Lead Medical Billing Specialist

• Manage the accounts receivable for timely and maximum reimbursement by adhering to company billing and collection policies.
• Review coding & charges, ensure the completion of team members daily task.
• Follow-up with external and internal customers to ensure remediation of customer issues.
• Communicate with the AR Manager concerning central billing issues, questions, concerns, corrective actions or training needs.
• Perform daily, monthly and special system processing requirements (i.e. batch posting and balancing).

Patient Access Specialist

• Responsible for the financial counseling, collecting co-pays and deductibles and/or providing financial assistance education to patients and their families
• Responsible for stat registering, scheduling appointments, completion of registration by collecting and entering all pertinent financial and demographic information into the ADT system
• Verifying insurance benefit information, generation of the ABN, reviewing orders for compliancy, completion of MSP, obtaining financial and treatment consents, placing of ordered medical procedures, obtaining a pre-certification when applicable
• Demonstrate Customer Focus with Patience, Composure, and Compassion
• Deal with Ambiguity by effectively coping with change; possess strong Time Management skills, Interpersonal Savvy, while supporting Peer Relationships
• Demonstrates expert Functional/Technical skills while providing financial assessment and evaluation of each patient entering the hospital
• Comprehend the hospital’s financial policies, possess the ability to apply it to the patient, and secure payment for the patient’s hospital liability
• Maintain excellent customer service standards at all times in order to effectively communicate with physicians, physician offices, patients, and co-workers
• Efficiently perform all duties while ensuring patient confidentiality and privacy rights

Financial Planning and Analysis

• The Patient Financial advocate is responsible for assisting patients and/or families to access financial resources.
• The Advocate assists and provides guidance to those patients who may qualify for assistance through state, county, and federal programs.
• The Advocate will also be responsible for revenue cycle processes including functions related to obtaining prior authorization, follow up, and benefit verification.
• Additionally, the Advocate will be available to patients and families to answer questions regarding their insurance and give estimates of co-pay amounts.

Patient Financial Advocate

Business Analyst

• Provide analytical, project management, and operational support to the Reimbursement & Chargemaster Departments
• Support Medicaid supplemental and state directed payment programs, cost reporting activities, and broader reimbursement initiatives
• Develop and maintain reporting tools, monitor key reimbursement metrics
• Assist with audit preparation and regulatory documentation
• Support budgeting and contractual analysis
• Evaluate workflows, identify opportunities for process improvement
• Serve as a liaison between Reimbursement, Managed Care, Revenue Cycle, Accounting, IT, and operational departments

Reimbursement Business Analyst

• Responsible for assisting patients and/or families to access financial resources
• Assists and provides guidance to patients who may qualify for assistance through state, county, and federal programs
• Responsible for revenue cycle processes including functions related to obtaining prior authorization, follow up, and benefit verification
• Available to patients and families to answer questions regarding their insurance and give estimates of co-pay amounts