The Revenue Cycle Management (RCM) Analyst uses analytical skills and attention to detail to drive success. They use a proactive approach and growth mindset to work effectively across functions, influence upstream process, and work to improve claims acceptance rates.
Responsibilities
Billing Optimization and Revenue Recovery :
- Analyze billing data to identify root causes of denials and inefficiencies, focusing on strategic improvements to increase claims acceptance rates, particularly for claims submitted to Centers for Medicare and Medicaid services
- Develop and implement solutions to optimize the billing cycle, ensuring compliance with strict medical billing guidelines and alignment with industry best practices
Advanced Data Analysis and Reporting :
Utilize strong proficiency in data analysis tools to create sophisticated models and reports that provide deep insights into billing processesPrepare detailed presentations that track denial trends, analyze billing performance, and provide actionable insights to senior managementUtilize strong root cause analysis (RCA) skills to identify and address system or process issues, providing actionable insights and solutions to improve overall efficiency and accuracy in billing and claims processesCross-Functional Collaboration :
Work closely with various departments including Enrollment, Payroll Operations, Tax Operations, and General Ledger to understand and influence the processes that impact billing outcomesAdvocate for necessary changes in upstream functions to reduce denials and enhance the efficiency of billing practices, ensuring alignment with billing requirementsSupport the implementation of Claims Manager by defining and optimizing related processes, and setting up comprehensive reporting to ensure smooth integration and operational efficiencyProcess Improvement :
Initiate process reviews and lead projects aimed at improving the overall efficiency and effectiveness of the billing processesEmploy advanced analytical tools and methodologies to develop forecasts and models that predict potential future challenges in billingMinimum Qualifications
Bachelor’s degree in Finance, Accounting, Business Administration, or related field3 years of experience in revenue cycle management, improving processes, and reducing denialsStrong proficiency in data analysis tools, particularly Excel, and familiarity with medical billing softwareExcellent analytical and problem-solving abilitiesDemonstrated ability to perform root cause analysis to identify and resolve underlying issues.Exceptional communication skills, with the ability to influence cross-functional teams and manage projects involving multiple stakeholdersA proactive, detail-oriented approach, with a relentless drive to pursue revenue optimization and process efficiencyPreferred Qualifications
Six Sigma / process improvement certificationsAcumen is an Equal Employment Opportunity (EEO) employer. We embrace diversity in all its form. We provide equal employment opportunities to all qualified applicants without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, age, protected veteran or disabled status, or genetic information.
If you require reasonable accommodation for any part of the application process or hiring process, please submit your request through one of the following methods listed below :
a) Dedicated fax 866-268-8885
b) Dedicated email hrdept@riseservicesinc.org DISABILITY ACCOMMODATION REQUESTS ONLY
c) US mail - 4554 E Inverness Ave Mesa, AZ 85206- Attn Human Resources
d) Dedicated phone 1-866-242-2714 Option 1 (Employment Opportunities) DISABILITY ACCOMMODATION REQUESTS ONLY
