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 or 3-5 years of revenue cycle/analytics experience required.
• Fundamental understanding of revenue cycle principles, the theory of bottlenecks, and use of data models to measure and predict outcomes of processes.
• Working knowledge of CPT, HCPCS coding, DSO reduction, accounts receivable, denial resolution, appeals, HIPAA regulations, and EDI claims submission methods.
• Advanced knowledge of Microsoft Excel (ability to clean, transform and merge data sets; perform complex data analytics)
• Experience with Business Information data tools, Looker, Xifin and Power BI 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.