Revenue Cycle Analyst- Full time days- Hybrid

Job Description

Position: Revenue Cycle Analyst

Reports To: Controller

Schedule: Full-time days- Hybrid

Position Location/Department: Accounting

Job Summary:

We are looking to hire a highly efficient Revenue Cycle Analyst to monitor, research, organize, and analyze data from various sources related to the revenue cycle at both the Hospital and RHC

Essential Duties and Responsibilities:

• Assist with preparation of Medicare, Tricare, Medicaid cost reports and related reimbursement studies.
• Responsible for annual CRNA reporting.
• Responsible for Medicare/Medicaid quarterly credit balance reports.
• Responsible for compliance with all provider regulations and laws governing the preparation of cost reports and other such submissions.
• Responsible for preparation of relevant A/R, departmental census End of Month Reports for Management review.
• Responsible for preparing monthly calculations to ensure accurate contractual adjustments for Medicare, Medicaid, Managed Care Payers, and any other payers and review calculations performed by others. Provide reasonable explanation of reimbursement contractuals/deductions as well as net revenue variance from budgeted levels on a monthly basis.
• Responsible for the review and/or calculation of appropriate bad debt/charity reserve amount (allowance for bad debt).
• Responsible for Payer Contract Management.
  • Work closely with 3rd Party Payer Contracting to ensure accurate set up of all payer contract terms in eCW, Thrive and TruBridge RCM.
  • Review reimbursement related payer regulatory changes and assists Senior Management in understanding and evaluating the impact of these changes and communications with insurance providers, billing processes, collections, cash posting validation, contract analysis.
• Communicates reimbursement related information to appropriate individuals throughout the organization and understands the concept of a full service reimbursement department.
• Responsible for the review, updating and subsequent implementation of the annual and daily Charge Master maintenance -price increase/adjustment. Perform periodic market rate setting for various procedures, Revenue Codes, CPT/HCPCS and work RVUs.
• Responsible for compiling monthly RVU reports for physician compensation.
• Responsible for performing root causes analysis and offer recommendation for improvement opportunities to ensure that accurate billing information captured in the billing system.
• Develop and maintain denial reports from eCW, Thrive, and TruBridge RCM to use for root cause analysis. Identify the source of the denials.
• Prepare, analyze and distribute monthly third party denials and prepare relevant reports regarding trends in denials. They will determine root causes of denials and work with the appropriate departments to establish processes to ensure prevention of the denials.
• Monitor KPIs standards for billing and coding.
• Preparation of Payer Scorecards to share with Managed Care Contract partners for use during contract renegotiations
• Attend Revenue Cycle and 3rd Party Payer Contract meetings as required.
• Other duties as assigned (i.e. adhoc reporting).

Education, Experience and Other Requirements:

• Bachelors degree in Finance, Business Administration, Healthcare Administration, or equivalent work related experience.
• Minimum of 5 years of relevant experience in Billing/coding
• Proficient in all Microsoft Office applications as well as medical office software.
• Proven experience in healthcare billing.
• Sound knowledge of health insurance providers.
• Strong interpersonal and organizational skills.
• Strong analytic skills and detail orientated.
• Excellent customer service skills.
• The ability to work in a fast-paced environment.