Revenue Cycle Analyst

SCOPE/GENERAL PURPOSE OF JOB:

Provide analysis and support for revenue cycle projects relating to the back-end process(billing). The analysis will be focused on transaction, denial, AR, and adjustment reports. By creating reports to identify key opportunities, further root cause analysis skills will be utilized within electronic medical record software to review claim status/follow-up, denial status/follow-up, as well as adjustments and write-offs. This position will work with clients to consult on back-end revenue cycle related opportunities that result from their analysis. Part of this position’s responsibilities will also be the creation and management of recurring clients monthly reporting of transactions, denials, and collections.  

ESSENTIAL DUTIES AND RESPONSIBILITIES:

• Analyze and interpret data from denials, AR, adjustment reports to identify trends, patterns and opportunities for improvement in the revenue cycle process
• Create reports with Excel and PowerBi to display client financial trends, strengths, and opportunities within the revenue cycle
• Utilize electronic medical record (EMR software) to perform foot cause analysis of billing related issues
• Complete summaries for client dashboards based on data pulled from EMR systems
• Collaborate with internal teams and external clients to understand the business requirements and objectives related to revenue cycle management
• Develop recommendations and strategies based on analysis findings to optimize revenue cycle back-end process performance
• Participate in meetings and presentations with clients to discuss analysis findings, recommendations and project progress
• Stay abreast of changes in healthcare regulations, reimbursement polices and industry standards related to revenue cycle management
• Collaborate with cross-functional teams to ensure alignment on project objectives and successful implementation of solutions   
• Additional duties as assigned.

EDUCATION AND/OR EXPERIENCE:

• Bachelor degree is required
• Master degree in science healthcare systems (MSHS) is preferred but not required

QUALIFICATIONS:

• 1-2 years of experience in a hospital financial setting is required  
• Healthcare industry experience required
• Experience creating reports utilizing data from transaction, denial, ATB, and adjustment reports
• Advanced skillset in Microsoft Excel
• In-depth understanding of denials and remark codes
• Experience reviewing EOBs and resolving open claims
• Thorough knowledge of payer billing requirements and policies
• Electronic Medical Record system experience (Cerner & Epic preferred)
• Complete understanding of the revenue cycle process
• Excellent communication skills to be effective with senior management, company leadership, and financial vendors