Revenue Cycle Performance Analyst serves as industry expert while they identify best revenue cycle practices in partner locations. Reporting into our Performance Analytics Manager, this position will be part of a small, fast-paced team taking on analytically focused projects that improve our revenue cycle performance. This position will directly impact the company's growth and our ability to provide a better patient experience at a time in their healthcare journey when they need help most.
You Will:
- Interpret basic revenue cycle and financial data. Maintain databases and templates, ensuring data integrity through monitoring and auditing outputs.
- Collect and assist in analyzing qualitative/quantitative data reports extracted from various systems.
- Incorporate results of statistical and qualitative analyses utilizing Microsoft Excel, Word, and Power BI.
- Proactively analyze data to identify and resolve potential issues that could have an adverse effect on revenue cycle performance.
- Apply healthcare economics concepts and tools to enhance understanding of utilization, quality, and performance patterns across healthcare networks.
- Collaborate with management staff to provide rigorous analysis supporting revenue cycle operational objectives.
- Prepare reports to evaluate and interpret data, monitor performance, identify trends, determine root causes, and update action plans to remedy issues.
- Develop financial and statistical reporting to use in the analysis, tracking, and trending of revenue cycle operation activities.
You Are:
- Bachelor's degree in Accounting, Business, Finance, Healthcare Administration, Computer Science, Analytics, or an equivalent combination of education and work-related experience.
- Effective at working both at a detailed data level and a strategic thinking level.
- Minimum of one year of experience with medical claim business system software.
- Minimum one year Health insurer industry experience, with business knowledge of benefits, claim systems, and adjudication principles.
- Minimum one year of medical and/or benefit policies, provider contract and/or employer plan designs, professional and facility claim processing, and medical terminology and industry-standard code sets (CPT-4, ICD-9-CM, ICD-10, etc.).
- Minimum one year experience managing multiple assignments, independently determining solutions, and anticipating/preventing potential problems.
- Minimum of one year of experience in Microsoft Excel and extensive use of data query logic.
- Knowledge in EDI transaction exposure such as 270, 271 for healthcare benefits and eligibility, 276, 277 for claims status and 278 for transmitting healthcare service information, 837 for submitting claims, 835 for payments, 834 for benefit enrollment, and 820 for premium payments to insurance products.
- Experience with Power BI modeling and presenting data insights.
- Proficiency in SQL for data extraction and manipulation.
- Strong skills in presenting and visualizing data for stakeholder communication.
To Ensure Success In This Role, You Must Have:
- Ability to communicate, cooperate, and function professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors.
- Demonstrates initiative, personal awareness, professionalism, and integrity and exercises confidentiality in all areas of performance.
- Follows all local, state, and federal laws concerning employment, including but not limited to: I-9, Harassment, EEOC, Civil rights, and ADA.
- Follows OSHA regulations, and site protocols, policies, and procedures.