Revenue Cycle Analyst

Position Summary:
The Revenue Cycle Analyst will be responsible for building and maintaining collaborative and productive relationships within the organization relating to Revenue Cycle Management, managing revenue cycle projects, driving performance in operations related to reimbursement and providing direction and oversight of processes impacting cash collections.

Primary Responsibilities:

• Serves as the primary source of knowledge for designated revenue cycle function (Prior Authorization, Eligibility & Insurance, Denials & Appeals, Claim Submission, etc).
• Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for designated revenue cycle function (Prior Authorization, Eligibility & Insurance, Denials & Appeals, Claim Submission, etc).
• Responsible for ensuring appropriate configuration of systems and workflows for designated revenue cycle function (Prior Authorization, Eligibility & Insurance, Denials & Appeals, Claim Submission, etc).
• Responsible for ongoing denial trend research and analysis, including evaluation of clinical, coding and reimbursement policies, and translating that information into action plans that drive end-to-end performance improvement.
• Establishes an ongoing working relationship with other departments impacting revenue cycle performance.
• Works closely with the vendor operations teams to oversight operations activity that directly impact the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.

• Tracks on-going performance of revenue cycle metrics and activities to ensure goals are met.
• Leads monthly meetings to review key metrics, trends and performance improvement opportunities.
• Incorporates awareness of end to end revenue cycle components to maximize revenues while adhering to compliance and quality policies and procedures.
• By continually reviewing and monitoring billing and coding changes, researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.
• Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.
• Develops goals and metrics to link department and revenue cycle initiatives with the organization's strategy.
• Leads committees and task forces needed to support revenue cycle initiatives. Demonstrates the ability to plan, direct and delegate tasks while ensuring deadlines are met.
• Develops, manages and monitors successful completion of implementation and project plans.
• Acts as a lead educator on performance improvement requirements in operations and methodologies to related teams and departments.
• Continuously seeks new and creative technologies that help identify and guide improvement opportunities that align with overall company success.

• Bachelors Degree in business or healthcare related field of study or equivalent experience.
• At least 5 years of experience in medical billing and Insurance collections.
• Knowledge of CPT/HCPCS. ICD-10, modifier selection, and UB revenue codes.

• Proficiency with medical billing systems, Microsoft Excel, medical terminology and basic procedure coding knowledge.
• Knowledge of medical terminology and abbreviations, and health care nomenclature and systems.
• Strong communication (verbal and written), organizational, problem solving and team player skills.
• Ability to navigate across multiple customer demands and balance competing priorities successfully.
• Ability to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner.
• Ability to focus on a problem or task and articulate a resolution in a prompt, productive and efficient manner.
• Maintains confidentiality of sensitive information.
• Requires advanced project management skills, must be able to manage multiple projects
• Analytical skills required.
• Requires strong coaching and mentoring skills.
• Ability to think critically and identify the global impact across the revenue cycle with a solution oriented approach.
• Ability to develop, implement and produce complex analysis and reports.
• Ability to motivate and create a team environment, prioritize work distribution, exceptional organizational and time management skills.

• This position is a remote position. It requires the ability to use a computer keyboard, communicate over the telephone and read printed material.
• Duties may require working outside normal working hours (evenings and weekends) at times.