What are the responsibilities and job description for the REVENUE CYCLE ANALYST position at Carson Tahoe Health?
Description
US:NV:Carson City Patient Financial Services
Full Time Day Shift
About Carson Tahoe Health
CTH is a not-for-profit healthcare system with 240 licensed acute care beds, fully accredited by the Center for Improvement in Healthcare Quality (CIHQ). CTH was voted 5 th most beautiful hospital in the nation nestled among the foothills of the Sierra Nevada in North Carson City and only a short drive away from world-famous Lake Tahoe & Reno. We serve a population of over 250,000 and feature two hospitals, two urgent cares, an emergent care center, outpatient services and a provider network with 19 regional locations.
Summary
The Revenue Cycle Analyst is responsible for payer contract management and integrity of contract management software across the Carson Tahoe Health system. Assists in negotiating contracts and understanding historical and future performance of existing contracts; reporting data to leadership. Troubleshoots negative trends in net revenue collection ratio and recommends solutions. Serves as a subject matter expert to the revenue cycle team in billing, collections, and payer performance. Supports the Patient Financial Services department in various projects to maintain key performance indicators.
Responsibilities
- Manages and maintains payer plans within Epic, facilitating education across the organization with regards to updates and/or changes and appropriate plan selection.
- Monitors and manages net revenue collection ratio for the Health System by identifying root causes for variances/underpayments and addressing any net revenue calculation issues or escalating to appropriate leadership.
- Performs a wide range of high-level and detailed analytical functions for contract management and negotiations, including but not limited to: forecasts on impact of reimbursement during negotiation process, maintaining contract management software with accurate reimbursement terms/timelines, and monitoring payments for compliance.
- Manages payer contract renewal timelines and facilitates periodic contract renewal review meetings with stakeholders.
- Maintains historical file of all system changes, contract negotiation communications, and reports.
- Monitors payer performance with respect to denials trends, Turnaround Time, and payment variances.
- Supports third party applications with payer contract updates, including but not limited to: pricing software, and underpayment recovery solutions.
- Actively communicates with internal and external customer(s) regarding data variances, denial management, revenue cycle workflows, compliance, and insurance plan issues.
- Prepares reports for first pass payer denials and assists with root-cause analysis as it relates to Epic configuration and payer related issues.
- May coordinate, analyze, and perform accounts receivables reduction projects to support the initiatives of the Patient Financial Services department and revenue cycle teams.
- Participates in Epic testing as necessary for application upgrades. Performs other related duties as assigned.
Qualifications
Education/Experience:
· Bachelor’s degree in business, healthcare administration, information systems, or similar field OR equivalent combination of experience in Epic payer contract management, Revenue Cycle analytics, Net revenue reimbursement calculations, Patient Financial Services leadership role, denials management or payer relations management of five (5) years.
· Certification in Epic contract management module or ability to obtain within six (6) months of hire.
Knowledge/Skills:
· Thorough knowledge and understanding of healthcare operations, including revenue and reimbursement processes.
· Strong analytical and interpersonal skills essential to establish relationships and communicate effectively with a wide variety of users. Must be a self-starter with the ability to multi-task and take initiative in a priority-driven environment.
Top 5 Reasons to Live in Carson City, Nevada
- Live, work and play in one of the most beautiful regions in the world
- Enjoy an array of outdoor activities world class skiing, golf, camping, mountain biking, hiking, water skiing, kayaking, hunting and fishing
- Just next door is Beautiful Lake Tahoe
- We are minutes from Reno known as the 'biggest little city in the world' - Fine dining, nightlife, shopping and home to the University of Nevada Reno.
- Family friendly atmosphere with affordable housing & excellent school system
Our Benefits
- No State Income Tax
- Medical, Dental, Vision, FSA, Telehealth
- Paid Time Off, Mental Health, and Volunteer Days
- 100% Vested 401K & Roth with Company Contribution
- Tuition Reimbursement
- Referral Bonuses
- On Site Education & Certification Programs
- Base Wage Increases for Relevant Advanced Degrees
- Free Calm App Subscription
