About the position
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. Expertise level of data presentation,
Ability to explain issues for their assigned business unit to different
levels of leadership from front line worker to C-suite. Expert ability in
creating visuals to present data in a concise manner.
• 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. Understands and utilizes their
expertise of the revenue cycle process from claim submission to receipt of
payment/write off. Able to pinpoint inefficiencies along the way and make
suggestions for process improvement.
• 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.
Requirements
• Bachelor’s degree in business, informatics, quantitative field or 3+ years
of revenue cycle/analytics experience
• 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) and experience with Business
Information data tools, Looker, Xifin and Power BI preferred.