Revenue Cycle Analyst

Description

COVID-19 vaccination NOT required for this position.

Job Summary:

The Revenue Cycle Analyst will closely work with the operations team and clinics as well as our insurance payers, acting as a subject matter expert (SME) to identify and resolve systemic payment issues within the RCM department. This includes RCM process analysis and improvements, participation in training and mentoring, as well as development and review of training and operational material. It also may include participation in the development and support of process automation.

In fulfilling the duties mentioned above, the position will extract, manipulate, analyze, and summarize utilization and internal USDP data, across multiple internal and external reporting platforms, to produce top-sided consolidated reports and analytics for review by key company stakeholders. This position will also be responsible for directly or indirectly driving RCM resources to resolve issues identified.  

Duties and Responsibilities:    

• Extracts, analyzes, summarizes claim data from the practice management system to identify contract compliance issues and underpayments.
• Maintain expertise regarding specific assigned payers, clinics ops, and RCM functional components.
• Maintains on-going project timelines and status with weekly updates to the team.
• Responsible for managing the resources related to owned projects and issues.
• Ensures data integrity and accuracy of all analysis and summary reports completed.
• Implements system changes and updates as required to support departmental operations.
• Identifies project issues and risks and help identify mitigation strategies.
• Works closely with and supports management to meet project goals.
• Completes audits and audit reports for functional areas of responsibility, reporting to management any concerns.
• Monitors productivity for all projects and functional areas of responsibility, reporting to management any concerns.
• Adheres to all safety policies and procedures in performing job duties and responsibilities while supporting a culture of high quality and great customer service.

Qualifications

Experience Requirements:

• 2 years with a degree or 4 years direct experience in the healthcare revenue cycle without a degree is required.
• 1 year(s) experience working within an AR team or Payment Posting team required.
• Ability to review a patient account and EOB is required.
• Intermediate to advanced experience (2-4 years) using MS Excel is required
• Intermediate to advanced experience (2-4 years) using function and pivots within MS Excel is required
• Project management skills is preferred.
• Excellent communication skills is required
• An equivalent combination of education and experience, which provides proficiency in the areas of responsibility listed above, may be substituted for the above requirements.

Knowledge, Skills and Abilities Requirements:

• Detail oriented, professional attitude, reliable
• Management and organizational skills to support the leadership of this function
• Ability to follow or provide verbal & written instructions with sufficient grammar and spelling skills to avoid mistakes or misinterpretations
• Ability to work successfully under tight timeframes
• Interpersonal skills to support customer service, functional, and teammate support needs
  • Able to communicate effectively in English, both verbally and in writing
• Mathematical and/or analytical ability intermediate to complex problem solving
• Intermediate computer operation
  • Experience with Microsoft Excel And Word.
• Specialty knowledge of systems relating to job function
• Knowledge of state and federal regulations; general understanding of HIPAA guidelines

Supervisory Responsibilities:

• This position will have responsibility to oversee resources on a project-by-project basis.