Revenue Cycle Analyst

Job Description

Revenue Cycle Analyst:

This job description outlines a role responsible for overseeing a customer's RCMS contract, ensuring the smooth functioning of the revenue cycle across multiple business accounts, and ensuring key performance indicators (KPIs) are met.

About The Role

The ideal candidate should have advanced RCM knowledge, problem-solving abilities, and experience in resolving complex customer issues. They will collaborate with teams, lead billing operations, and report monthly performance.

Responsibilities

• Oversee a customer's RCMS contract
• Ensure the smooth functioning of the revenue cycle across multiple business accounts
• Ensure key performance indicators (KPIs) are met
• Collaborate with teams
• Lead billing operations
• Report monthly performance
• Responsible for providing oversight of a customer's RCMS contract
• Ability to address multiple markets of business accounts
• Ensure the revenue cycle is processing appropriately and KPIs are within expected parameters
  
  

Knowledge & Application

• Exhibits advanced RCM knowledge
• Possess wide-ranging experience using in-depth professional knowledge, acumen, concepts, and company objectives to develop and resolve complex customer business requirements
• Provides solutions to issues in creative and effective ways, understanding the interrelationships of different EHR functionality and impacts
• Complexity & Problem Solving: Advises on or serves as advisor on complex customer issue analysis that requires evaluation of identifiable factors
• Devises solutions based on limited information and precedent and adapts existing approaches to resolve issues
• Uses advanced knowledge, evaluation, judgment, and interpretation to select the right course of action
• Assesses agency billing requirements, EDI files, and other RCM processes, seeks collaborative solutions, and prepares and presents recommendations
• Resolves concerns with team members with minimal support from leadership to ensure a productive revenue cycle
• Leads an identified effort of complex RCM billing and reporting requirements, seeks collaborative solutions, and prepares and presents recommendations
• Excellent written and oral communication skills
• Ability to think quickly and logically to ensure solutions are identified
• Strong attention to detail and follow-through skills
  
  

Duties And Responsibilities

• Maintain & coordinate billing operations and support actions with other team members
• Lead efforts in payer and industry research impacting customers businesses
• Coordinate with team members to ensure metrics are met for contracts assigned
• Maintain skills of Senior Billing Specialist; step in and help team members to maintain contractual KPIs
• Monitor accounts for KPI performance and escalations
• Creation of month-end reporting and submission to provider practices
• Assist in process development
• Substantial understanding of medical billing, revenue cycle, and application of knowledge and skills to oversee customer contract(s)
• Identify trends, root causes, and design solutions with minimal leadership support
  
  

Qualifications

• Bachelor's degree and 6–8 years of medical billing experience
• Excellent Excel skills
• Ability to identify trends and design solutions independently
  
  

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.