Careers

Updated: March 6, 2009

Dispute Resolution Tool Box

BUSINESS ANALYST

The Medical Banking Project drives lower healthcare costs by researching and facilitating cross-industry models that optimize banking resources for healthcare. Established in May 2001, the Project is a self-funded and pragmatic think tank comprised of industry leaders, legal analysts, writers and studio production experts who support initiatives such as the Dispute Resolution Initiative (DRI).

DRI convenes professionals charged with developing a set of recommendations, a matrix and a database for rationalizing the large number of denial reason codes in medical claims processing. This project seeks to launch a forum to facilitate the implementation of standardized denial reason codes in the marketplace.

Project Description

You will gather and define financial requirements using systems analysis techniques. Your responsibilities will include conducting a needs analysis, process documentation and system testing as necessary. You will utilize your excellent communication and professional skills as you interact with payers and providers coordinating the analysis, testing and implementation of upload requests and key claim or record adjustments. You exhibit organization expertise, and frequently manage multiple tasks and follow their progress to completion.

The Business Analyst will have overall responsibility for maintaining a database of payer reason codes mapped to ANSI codes and a Medical Banking Project (MBP) Usage Matrix.

Qualifications:  

• Seven to ten years of professional healthcare patient financial services experience
• Extensive knowledge of the practices of various payers regarding their use of claim adjustment reason codes
• Extensive knowledge of the ANSI code sets
• Experience working independently and excellent communication skills.
• Skilled in the use of Microsoft Office; (Excel is a must)
• Experience is the use of online communication tools such as WebEx or Microsoft Meeting.
• Experience with HIPAA regulations, will know the provider patient accounting or payer processing for 837 claims and 835 remittances with a solid understanding of the denial/appeal process.
• College Degree preferred or equivalent
• Edifecs’ solution processing experience a plus (i.e.: SpecBuilder, HTR, etc…)

Specific responsibilities:

• Receive data from numerous sources including Members of The Medical Banking Project, payers, providers and other entities who may decide to support this project
• QA and assess validity and accuracy of data
• Use experience and judgment to map any proprietary data (non-ANSI) to ANSI standard code and then to the appropriate MBP Usage Matrix
• Interact with members of the Dispute Resolution Initiative Workgroup
• Send completed data files to webmaster for inclusion on the website.
• Be available to answer questions from users of the database

The position is being offered on contract basis and will report to the Executive Director of The Medical Banking Project. Hours are flexible and based remotely from an existing and dedicated home office or telecommute from the Nashville, TN office.

Primary Location: USA/Franklin, TN

Organization: The Medical Banking Project, Franklin, TN

Category: Finance/Healthcare

Schedule: Flexible hours; approximately 10 hours per week to start; may be home-based or telecommute.

Contract Rate: $16.00 per hour plus approved travel expenses

Qualified applicants will send a formatted resume in .doc via email to: info@mbproject.org.

In The Tool Shed for 2009:

-- A HIPAA Compliance Guide for Banks

-- Executive Training Program for sales professionals and medical banking strategists (MBS and MBP)

-- The HIE Landscape: How Banks Can Fast Forward E-Health