The Role:
The Financial Analyst - RCM will take the lead on developing tools, methodologies, and data analytics to support the Revenue Cycle Management/Billing team in monitoring client financial data and performance metrics. This role will collaborate with the RCM Client Success Team to analyze charges, payments, encounters, A/R, and denials data for clients, and improve performance by decreasing the percentage of denials, improving collections on claims, and identifying practice/payor trends.
Opportunity Highlights:
· Opportunity to take on a visible, impactful role, working directly under the Corporate Finance Manager, and supporting the lifeblood of the company – the RCM process. This role will perform data analysis that will directly drive and maximize the company’s top line performance.
· Leverage advanced SQL and Data Analytics tools to manipulate, analyze, and present critical data, and tell highly informative stories for a core group of internal customers and deliverables.
· Join a company that seeks to develop and grow talent, where leaders have moved up over many years from individual contributors to Director, VP, and even C-level roles.
· Play a key role in a company mission that will transform and improve a healthcare system in need of evolution and improved accessibility.
· Enjoy a flexible, straight forward, open-door management style. Work hard but also enjoy balance and camaraderie in a culture comprising down-to-earth people, no-drama attitudes, and a team mindset.
Key Performance Metrics & Objectives:
· Lead execution of RCM data collection, reporting, analysis, and delivery of key metrics, developing and maintaining consistent, actionable data for the billing department.
· Leverage skills in SQL, Power Query, and Excel to pull / manipulate large data sets from core systems such as the NextGen patient management, Microsoft Dynamics ERP, and ADP.
· Work with the billing team to determine analytics needs, and develop data sets and analyses in Excel (and PowerBI to a lesser extent) that illuminate revenue cycle trends and answer question/solve issues regarding RCM performance.
· Manage the SQL query and data collection process from query writing to validation - Design SQL queries from scratch, research and validate relationships across multiple tables and databases, and validate output against source systems and existing reports to ensure accuracy.
Core Day-to-Day Accountabilities:
· Identify opportunities to improve revenue and collection performance through analysis of charges, claim denials, payments, accounts receivable, and escalated client metrics.
· Monitor operational key performance indicators to identify the root cause of poor performing metrics and make recommendations for improvement.
· Assist management in developing meaningful reports, KPIs and summaries that provide support to the RCM team.
· Generate standard and custom statistical and analytical reports as requested by RCM Leadership using the NextGen patient management system, Microsoft Excel, and/or SQL.
· Complete Ad Hoc report requests as assigned by management.
· Establish complementary and collaborative relationships with appropriate stakeholders/committee members, and RCM Leadership.
· Maintain and/or automate frequency-based reports and dashboards, and manage any update/enhancement requests from RCM leadership
· Think critically about the business – continuously ask WHY, determine the story behind the data, and translate this into answers to questions and solutions to problems.
Core Competencies:
· 3 years of experience in financial/data analysis, in a healthcare business or similar business model that generates large data sets; preferred multi-site/state experience.
· Deep understanding of database concepts and structures, including ability to write, troubleshoot, and validate queries using T-SQL or similar language.
· Mastery of business intelligence visualization tools including Power BI.
· Working experience in creating, maintaining and troubleshooting data and reports, with in-depth data validation of new reports/queries against source systems and existing reporting products.
· Advanced excel skills such as the ability to use formulas, VLOOKUPS, HLOOKUPS, and index matches to analyze data, tables, and formatting. Strong skills in Power Query and Power Pivot.
· Demonstrated expertise OR aptitude for learning concepts in medical billing, front-office, physician practice management, claims processing and root cause analysis, and healthcare business processes.
· Deep knowledge or willingness to build knowledge of the revenue cycle process for claim submission, medical insurance policies, ICD-10 and CPT coding guidelines, common denial reasons, Fee for Service, Capitation, and Workers Compensation.
· Excellent time management skills in order to produce timely reporting, including the ability to swiftly move between projects to support high-priority, short turn around, ad hoc requests. Ability to quickly get up to speed with new systems and unfamiliar data relationships.
· Experience delivering reporting to C-Suite / Board-level stakeholders, and working with outside partners.
· Bachelor’s Degree, MBA a plus.
· Strong plus for experience with Great Plains, FRx Reporting, and/or Crystal Reporting.
Core Company / Team Fit Characteristics:
· Independent. You think for yourself and self-motivate to deliver work product on time. You take the initiative to dig deep and learn, speak up with ideas, while asking questions and for help when needed.
· Creative Problem Solver. You are tenacious and persistent in finding answers, determining root causes of outliers, and in figuring out creative solutions to solve team or business problems.
· Sense of humor. You’re looking for a team that is professional and delivers excellent work product, but all with a sense of humor and willingness to relax and have fun together.
· Flexible. You are willing to flex and roll with the punches when priorities shift or when there is a need to shift urgency to a new or different project.
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