Remote - Revenue Cycle Management Analyst

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timePosted 5 days ago location United States salarySalary undisclosed
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Job Description

RCM Analyst Level II Job Description New Season Employee Name: Reports to: Revenue Cycle Manager Department: Revenue Cycle FLSA: Exempt Direct Reports: 0

Job Summary:

Under limited supervision, this position will support the data needs of the Revenue Cycle and Payor Relations. The position will also oversee and maintain claims data in a HIPAA-compliant format with all content being cross-referenced against other databases to ensure accuracy and consistency. This position will establish Methasoft payer rate groups, billable services, fee schedules, CPT/HCPCS/ICD10 configurations and claim formatting; working in collaboration with the core IT Business Applications department.

Essential Functions:

  • Facilitates, advises and provides support to the revenue cycle team with configuration and data requests.
  • Strong data management and computer skills including reporting and database terminology, development of spreadsheets, analysis and manipulation of complex data from multiple data sources.
  • Utilize analytical skills necessary to review and identify reporting/data errors and develop corrective action plans.
  • Sound data analytics skills including: comfort with large data sets, knowledge of common revenue cycle key performance indicators, and attention to detail.
  • Performs data analysis to include the use of various technical tools in order to extract requirements, identify data inaccuracies, and ensure accurate processing and reporting.
  • Successfully drive operational change within a revenue cycle setting including increasing patient and insurance cash collections, reducing bad debt rates, increasing screening and conversion rates, improving clean claim rate, decreasing initial denial rate, etc.
  • Experience in drafting and delivering presentations to key stakeholders including revenue cycle leadership.
  • Provides support for ongoing development, maintenance, and remediation of reports that have been developed as systems are upgraded or changed.
  • Keeps lines of communication open with the Clinic Operations Team to ensure individualized goals are met.
  • Adheres to the service policy and principles of CMG/New seasons.
  • Other duties as assigned. Supervisory Responsibilities: None Essential Qualifications: (To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the competencies (minimum knowledge, skill, and ability) required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions). Education/Licensure/Certification: This position requires a Bachelor's Degree in computer science or similar discipline. Required Knowledge: The candidate will be familiar with healthcare transaction sets including claims, verification, remittance and authorization. Working with complex software systems, data tables, downloads, and data warehousing, and are critical knowledge bases. Additionally, the ideal candidate will demonstrate the ability to perform testing on records to produce custom output. Experience Required: The candidate has prior work experience in a healthcare setting; in particular, a large health system or a multi-state outpatient service provider. The candidate will also have a working knowledge of database/database structure/queries such as MS SQL, MySQL, etc. The ideal candidate will also have working knowledge of Reporting/Analytics tools such as Clicdata/PowerBi/Tableau, Crystal Reports, MS RS, etc. Skill and Ability: The ideal candidate will demonstrate the ability to work collaboratively and value input from stakeholders within the organization. Requires excellent communication, and analytical, facilitation and problem-solving skills. Must be a self-directed, strong team player with ability to establish sound and effective goals and turn them into action. Ability to successfully multitask and manage workflow priorities. Ability to expand knowledge of various applications and other related tools to maximize potential. Physical Demands/Work Environment: (The physical demands and work environment characteristics described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.) Finger Dexterity: Use primarily for writing, operating calculator, telephone, keyboard and other office equipment. Talking: To convey detailed or important instructions to employees, patients and applicants. Hearing:Ability to hear normal conversations and receive ordinary information. Vision:Average, ordinary, visual acuity necessary to observe patients and work on the computer. Clear vision at 20 inches or less and distant vision at 20 feet or more. Physical Strength:Sedentary work; sitting most of the time. Exerts up to 10 pounds of force occasionally. Working Conditions: (The working conditions described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.)
  • Ability to operate in an open work area with moderate everyday noise. Core Competencies: ➢ Analytical Skills ➢ Business Acumen/Understanding the Organization ➢ Communication ➢ Detail Orientation/Attention to Detail ➢ Ethics/Values/Integrity ➢ Information Gathering ➢ Problem Solving ➢ Time Management Mental Activities: (The mental activities described here are representative of those that must be met by an employee to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.) Reasoning Ability: Ability to resolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form. Ability to maintain confidentiality. Mathematics Ability: Basic mathematics (including statistics) skills required. Language Ability: Be able to communicate fluently in English, second language proficiency helpful. Education/Licensure/Certification: This position requires a Bachelor's Degree in computer science or similar discipline. Required Knowledge: The candidate will be familiar with healthcare transaction sets including claims, verification, remittance and authorization. Working with complex software systems, data tables, downloads, and data warehousing, and are critical knowledge bases. Additionally, the ideal candidate will demonstrate the ability to perform testing on records to produce custom output. Experience Required: The candidate has prior work experience in a healthcare setting; in particular, a large health system or a multi-state outpatient service provider. The candidate will also have a working knowledge of database/database structure/queries such as MS SQL, MySQL, etc. The ideal candidate will also have a working knowledge of Reporting/Analytics tools such as Clicdata/PowerBi/Tableau, Crystal Reports, MS RS, etc Equal Opportunity Employer Minorities/Women/Protected Veterans/Disabled