Pricing Analyst - Rice Home Medical

The Pricing Analyst/Cost Accountant is responsible for

collecting, analyzing, and evaluating data from internal and external sources on products, costs, and product markets to assist in providing pricing recommendations, quotes, and margin analysis to senior management. This position plays a key role in ensuring complete, accurate price tables are maintained and updated continuously to support revenue generation through accurate charge capture, Payer-compliant coding, and efficient billing processes that adhere to Payer guidelines and requirements.


• JOB RELATIONSHIPS:

A. REPORTS TO: Director of Rice Home Medical

B. SUPERVISES: N/A

C. INTERRELATIONSHIPS WITH: Directors, Managers, Revenue Cycle, Procurement, Manages, customer service representatives, sales and marketing throughout the CentraCare and Carris Organizations.


• HOURS OF WORK: 8:00am to 5pm -- 5 days a week
• DRESS CODE: Per Department Dress Code (Office attire)
• ESSENTIAL REQUIREMENTS OF WORK (Minimum qualifications necessary

to function at full productivity).

A. EDUCATION AND TRAINING: Degree in Finance or Accounting. Minimum of two year associates degree or equivalent experience in a Healthcare setting. Requires advanced knowledge of Microsoft Office applications (particularly Microsoft Excel), and other technology as assigned.

B. EXPERIENCE: Experience in data entry and computer skills is required. Specific experience related to medical terminology, charge documentation, coding, auditing, and Payer contracts a plus.

C. JOB KNOWLEDGE (Specific): Proficient at payment review. Overall

knowledge of business office procedures and policies. Strong problem- solving, interpersonal, analytical, communication and computer skills required. Ability to effectively use and integrate all necessary software systems a must. Emphasis on confidentiality and accuracy of information. Must be a quick learner and a self-starter.


• BUDGET: N/A
• CLIENTELE DIRECTLY AFFECTED BY JOB: This position will interact with all

areas of the Rice Healthcare Organization.
• PHYSICAL DEMANDS OF THE JOB: Minimal physical demands

1. Continuous sitting occurs while working at a work station, using a computer, and attending meetings 2. Frequent use of a telephone while holding it in the non-dominant hand and using the dominant hand for writing or using a keyboard 3. Occasional forward reaching from floor to above the shoulders - to file papers and remove them as needed 4. Approximate range is 60" from the floor


• PHYSICAL ENVIRONMENT OF THE JOB: Usual working conditions involving

adequate light, temperature, ample desk space, etc.
• EQUIPMENT OR MACHINES USED ON THE JOB: Computers, web-based

applications, internal software applications, printer, scanner, external storage devices, telephone, calculator, copy/fax machines, and other technology as necessary.


• MENTAL DEMANDS OF THE JOB: Candidate must be able to manage

multiple projects, multitask work with many different personalities, as well as stressful situations and be able to function as a polite and cooperative team member with a positive attitude. Candidate should possess good analytical and problem solving skills as well as mathematical ability. Good oral and written communication skills. People sensitive characteristics with a desire to help others.

A. JUDGEMENT AND INITIATIVE: Demonstrates good judgment.. Required to

accurately determine appropriate item coding making analytical judgment calls when necessary. Demonstrates ability to analyze information, plan effective actions and follow through reliably to meet expectations. Ability to interact with all Clinical staff objectively. Effective oral and written communications skills. Functions independently and as team member. Able to prioritize work projects and complete them in a timely manner. Has knowledge of hospital systems and organizational relationships.

B. INDEPENDENT ACTION: Required to make daily decisions specific to item

coding and pricing following Rice Home Medical policies. Ability to analyze situations, develop options and make mature judgments. Analysis of estimates and quotes and information. Enforce process improvement practices. Organizational skills needed to work and function independently with minimal supervision. Self-motivated; ability to set priorities and complete tasks on a timely basis. Ability to handle information in a confidential manner and work effectively and objectively with both Clinical and Non-Clinical staff

C. EFFECT OF ERROR: Negative effect on financial condition of Rice Home

Medical and Rice Memorial Hospital as well as customer dissatisfaction due to improper analysis, reimbursement miscalculations, and incorrect unit of measure assignment. In addition, inaccurate data is unacceptable and must be prevented at all costs whenever possible, as it presents the possibility of inhibiting issue recognition and resolution and can negatively impact public relations, patient satisfaction, etc.

D. CONTACT WITH OTHERS: Must be able to deal with a wide variety of

personalities in the Rice Organization demonstrating commitment to the principals, values, standards, and ethics of the organization. Demonstrates timeliness, courtesy, sincerity, and patients when dealing with customers and employees. Promote the company in a positive and professional manner.


• PRINCIPAL JOB RESPONSIBILITIES, TASKS, AND AUTHORITIES:

A. RESPONSIBILITY: Maintain Price Tables

PRIORITY: A % OF TIME: 65% DISCRETION: A TASKS:

1. Ensure price tables are correct and ensure the charge amount is in line with Rice Home Medical guidelines

2. Assign necessary rental periods, billing cycles and convert to purchase features per payer consulting with billing as needed

3. Ensure the appropriate price table is assigned to the correct item. 4. Calculates and enters correct billing units. (Based on the units of

measure) 5. Verifies payer allowable and maintains as needed. 6. Establish and maintain retail pricing. 7. Expire and create new price tables as needed 8. Assists with reporting projects related to pricing and reimbursement

as requested.

B. RESPONSIBILITY: New Product Number and Item Group Set Up. PRIORITY: A % OF TIME: 30% DISCRETION: A

TASKS:

1. Find the correct procedure code and insurance allowable amount for new item and quote requests.

2. Identified poor reimbursable items, pricing concerns, etc. and coordinates communication.

3. Creates Item Groups to facilitate with reporting and searches based on readily identifiable types of product.

D. RESPONSIBILITY: Preform Other Related Duties Assigned PRIORITY: A % OF TIME: 5% DISCRETION: A TASKS:

1. Responsible for attendance at in store in-services and meetings and other workshops to stay current with job responsibilities and a minimum of 6 hours of education each year.

2. Punctual attendance without habitual tardiness or absence without authorization.

3. Maintain customer confidentiality and adhere to HIPPA regulations in relation to customers PHI at all times.

4. Preform other duties assigned by management

E. RESPONSIBILITY: Service Excellence

PRIORITY: A % OF TIME: (ONGOING) DISCRETION: A TASKS:

1. Demonstrate an ongoing commitment to the Service Excellence philosophy by adhering to and promoting behaviors outlined in "Standards of Excellence".

F. RESPONSIBILITY: Continuous Quality Improvement

PRIORITY: A % OF TIME: (ONGOING) DISCRETION: A

TASKS:

1. Demonstrate understanding of the CQI philosophy. a) Participate in CQI training activities or CQI teams if

appropriate. b) Demonstrate sensitivity to customers and their needs. c) Interact appropriately with internal customers, i.e. coworkers

within department, staff across departments. d) Interact appropriately with external customers, i.e. patients,

families, staff, vendors. e) Role model positive behaviors.

G. RESPONSIBILITY: Safety

PRIORITY: A % OF TIME: (ONGOING) DISCRETION: A

TASKS:

1. Maintain and promote a safe environment for all visitors and staff. 2. Consistently follow all policies, practices and work rules. 3. Do not use shortcuts or work-a-rounds that may reduce safety or

increase risk. 4. Stay alert, act responsibly and use common sense to reduce risks. 5. Report actual events and good catches as soon as possible. 6. Eliminate hazards and identify and report unsafe systems. 7. Complete all mandatory safety education and attend safety

sessions. 8. Review and understand the Safety Program as identified by Rice

Home Medical safety Committee. 9. Seek answers to questions you have about the Safety Program.

04/2015