Revenue Cycle Analyst II

Overview

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

Responsibilities

• Effectively communicate problems, root causes, and proposed solutions to the Analytics team and stakeholders.
• Develop and 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.
• Present root cause analysis data findings with conciseness and recommendations following a data story format. Guide trainings over excel or analytic functions to billing members.
• Builds data models and dashboards to support consistent, accurate and timely analysis that supports improving collections, developing more accurate collection processes, and improving efficiency and automation.
• Develops a thorough understanding of reporting systems, billing and analytic processes and payor-specific reimbursement and billing requirements, contributing in the proactive identification of opportunities for revenue cycle improvement and enhancement including identifying trends to resolve denials.
• Participate and, at times, represent Revenue Cycle in ASP meetings and discussions.
• Develops relationships with revenue cycle vendors to ensure vendor performance and quality meets or exceeds standards set for those relationships.
• Measures and suggests improvements in clinically based appeal strategies.
• Assists in PAMA reporting for new and existing tests with accuracy and timely delivery to the Vice President for regulatory reporting.
• Evaluate claim processing outcomes to improve the internal cost estimating engine and make revenue processing recommendations.

Qualifications

• Bachelor's degree in business, informatics, or a quantitative field required.
• Fundamental understanding of revenue cycle principles, the theory of bottlenecks, and use of data models to measure and predict outcomes of processes required.
• Working knowledge of ICD-10, CPT, HCPCS coding, DSO reduction, accounts receivable, HIPAA regulations, and EDI claims submission methods required.
• Advanced knowledge of Microsoft Excel and experience with data tools required.
• Looker experience highly preferred.
• Analytical skills- understands the revenue cycle of insurance billing and can perform root cause analysis to identify process issues and suggest improvements highly preferred.
• Presentation skills- Able to present complex ideas clearly. Strong written and verbal skills. Advanced ability to create visuals to tell a data story highly 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.

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