Revenue Cycle Analyst

CITC ENTERPRISES, INC.

JOB DESCRIPTION

Job Title:         Revenue Cycle Analyst

Department:   CEI Finance

Reports To:     Senior Manager Revenue Cycle, CEI Finance

Supervises:      None

FLSA Status:   Exempt

Pay Grade:       E5

Job Type:         Regular, Full-time

AKBCU:           No       ICPA: No

General Functions:  

The Revenue Cycle Analyst will be responsible for both the detailed management of revenue cycle processes and the analysis and improvement of financial systems related to the revenue cycle. This role involves reviewing and submitting claims, performing account follow-up activities, analyzing financial data, ensuring data integrity, and supporting financial reporting and decision-making processes. The analyst must have expert knowledge of Federal and State regulatory requirements, payor contracts, financial systems, and CITC policies.

Duties and Responsibilities: 

• Resolve issues with participant registration and claim information. 
• Review documentation and billing for accuracy and compliance. 
• Manage multiple tasks, projects, and deadlines simultaneously.
• Analyze financial data and develop financial systems.
• Ensure compliance with Federal and State regulations.
• Collaborate with IT, product, operations, and finance teams.
• Provide training and support for staff.
• Research, analyze, and resolve complex cases and problem accounts.
• Submit and track the resolution of provider queries.
• Verify charges and correct as needed.
• Work aged receivables and review adjudicated claims.
• Post third-party payor(s), Medicaid, and patient payments.
• Assist other staff as needed to keep the department workload current.
• Assist with system configuration changes.
• Develop and document systems and processes with an enterprise perspective.
• Prepare and conduct system training for users.
• Maintain communication with all interested parties regarding patient account issues.
• Verification of healthcare coverage and coordination of benefits.
• Submit service authorization requests, follow up on pending requests, and monitor utilization.

Job Specifications:  

• Knowledge of medical electronic billing procedures and financial systems.
• Proficient computer skills, including Microsoft Office applications.
• Strong analytical, problem-solving, and decision-making skills.
• Ability to work under pressure and manage conflict.
• Knowledge of general accounting principles, revenue cycle processes, medical insurance, and associated regulations.
• High degree of accuracy and attention to detail.
• Strong customer service and negotiation skills.
• Excellent verbal and written communication skills.
• Must be an advocate for process improvement.
• Needs strong time management skills with the ability to effectively prioritize tasks.
• Experience with billing compliance based on Federal and State regulations.

Job Responsibilities Related to Participant Privacy

• Employee is expected to actively participate in CITC privacy training and to protect the privacy of participant information in accordance with CITC's privacy policies, procedures and practices, as required by federal and state law.  Failure to comply with CITC's policies and procedures on participant privacy may result in disciplinary action up to and including termination of employment.
• Employee may access protected health information and other participant information only to the extent necessary to complete job duties.  Employee may only share such information on a need to know basis with others who have job responsibilities related to treatment, payment, or other CITC operations.
• Employee is encouraged and expected to report, without the threat of retaliation, any concerns regarding CITC's policies and procedures on participant privacy and any observed practices in violation of the policy to the designated Privacy Officer.

Minimum Core Competencies: CITC Values, Respectful Leadership, Professionalism, Emotional Intelligence, Problem Solving/Critical Thinking, Communication Skills. 

Minimum Qualifications:

• Bachelor's degree in finance, accounting, or a related field.  Relevant experience may substitute for the education requirement on a year-for-year basis.
• Five years of billing revenue cycle experience.
• Three years of experience in financial systems analysis.
• Continued employment is contingent upon satisfactory completion of state and federal background checks.

Preferred Qualifications: 

• Master's degree in finance, accounting, or a related field.
• Alaska Behavioral Health billing experience.
• Experience with tribal/IHS financial systems.

Physical Requirements: The physical demands described here are representative of those that must be met by an employee to successfully perform the essential functions of this job.

• May require prolonged periods of sitting at a desk and consistently working on a computer with repetitive motion.
• The need to occasionally move around the office to access filing cabinets, storage cabinets, and office equipment may be necessary.
• Must be able to lift up to 25 pounds occasionally by utilizing proper lifting techniques and working in a safe manner.

Disclaimer

The information provided in this description has been designed to indicate the general nature and level of work performed by incumbents within this job.  It is not designed to be interpreted as a comprehensive inventory of all duties, responsibilities, qualifications and working conditions required of employees assigned to this job.  Management has sole discretion to add or modify duties of the job and to designate other functions as essential at any time.  This job description is not an employment agreement or contract.