Revenue Cycle Analyst

Overview

The Revenue Cycle Analyst supports a culture of excellence and improvement by acting as a key thought partner, engaging the Revenue Cycle Management team.

Responsibility

1. Provide guidance on processes, and reimbursement mechanisms to proactively identify opportunities of improvement.
2. Utilize data to perform root cause analysis to improve efficiency and automation in the Revenue Cycle.
3. Provide guidance in medical policy guidelines to assist in system automation modifiers, improve collections, and decrease outstanding work.
4. Maintain and update fee schedules and support audit requests. Ability to comprehend medical billing contracts and make internal system updates to align with those contracts.
5. Evaluate and coordinate reporting and updates related to patient cost estimate eligibility, reporting, and rule updates. Assist in creating logic for generating patient cost estimates. This includes understanding patient cost share and ability to recognize payor trends to make data driven updates to current estimate rules.
6. Effectively communicate problems, root causes, and proposed solutions to Analytics team and stakeholders.
7. Support the tracking of action plans, preparing analysis and using data to plan, organize, manage, and control collection processes. Able to present findings in a data story format.
8. Adhere to a cadence of timely reporting and delivery of business analysis to stakeholders, including reporting key metrics. Assist management with tracking issue action plans to ensure timely collection and follow-up.
9. Coordinate payor reviews with Revenue Cycle and operations leaders to meet company goals, driving a culture of continuous improvement through the analysis of business unit specific KPI’s and the applicable data drivers.
10. Assists in PAMA reporting for new and existing tests with accuracy and timely delivery to the Vice President for regulatory reporting.

Qualifications

1. High school diploma or GED required; bachelor’s degree in accounting, finance, analytic or healthcare related degree preferred.
2. 1+ year of healthcare or insurance contracting experience preferred, a mix of analytics-related schooling and relevant medical billing experience may be substituted for a degree.
3. Fundamental understanding of Revenue Cycle principles, CPT and HCPCS coding.
4. Working knowledge of DSO reduction, accounts receivable, HIPAA regulations, and EDI claims submission methods.
5. Intermediate knowledge of Microsoft Excel (pivot tables, formulas) and PowerPoint.
6. Experience with data tools (Xifin and Looker) preferred.

Physical Requirements

Lifting Requirements – light work or exerting up to 20 pounds of force frequently. Physical Requirements – stationary positioning, moving, operating, ascending/descending, communicating, observing, pushing or pulling, and reaching. Use of equipment and tools necessary to perform essential job functions.

EEO

We recognize that our people are our strength and the diverse talents they bring to our global workforce are directly linked to our success. We are an equal opportunity employer and place a high value on diversity and inclusion at our company. In hiring and all other employment decisions, we prohibit discrimination and harassment on the basis of any protected characteristic, including race, religion, color, national origin, gender, sexual orientation, gender identity, gender expression, age, marital or veteran status, pregnancy or disability, or any other basis protected under applicable law. In accordance with applicable law, we make reasonable accommodations for applicants’ and employees’ religious practices and beliefs, as well as any mental health or physical disability needs.