Revenue Cycle Analyst

Job Details Description

The role involves preparing ad‑hoc reports, analyses, and supportive data to aid operations and decision making, maintaining confidentiality with patient PHI and organizational information, providing project‑management support to various teams (e.g., Denials Team, Medicare value‑based programs), troubleshooting revenue‑cycle‑related queries from clinical departments, liaising with management and senior leadership to provide essential data, extracting and analyzing data, mining data from financial decision‑support systems, preparing data requests from internal and external customers, completing quarterly state Wraparound reports for Rural Health Clinics, conducting financial analyses of patient claim detail to support PMCN entities, and performing other assigned duties.

• Prepares ad hoc reports, analyses, and supportive data to support operations and decision making
• Maintains confidentiality while working with patient protected health information and confidential organization information
• Provides project management support as needed for any new or existing teams, e.g., Denials Team, Medicare value‑based programs, etc.
• Troubleshoots and researches questions or issues raised by revenue cycle or clinical departments related to revenue cycle functions
• Interacts with Management and Senior Leadership to provide the necessary data required to make effective decisions
• Responsible for extracting, analyzing, monitoring, and studying data
• Data mining from financial decision support systems or applicable financial data repositories or databases utilizing analytical tools, operational/clinical metrics, payer reimbursement analysis
• Prepare ad hoc data and analysis requests from internal and external customers
• Complete quarterly state Wraparound reports for the Rural Health Clinics
• Assists in the financial analyses of patient claim detail to aid the PMCN entities in revenue cycle analyses to develop insights and understand trends
• Performs other duties as assigned

• Bachelor’s degree in health management, finance, accounting, mathematics, or related field is required
• Knowledge of insurance carriers, HCPCs, CPT codes, MS‑DRGs, diagnosis codes, and other healthcare related terminology
• Knowledge of payor payment methodologies
• Two to three years of experience of successfully applying technical and systems skills with advanced data and database manipulation skills in a health care setting
• Solid working knowledge of healthcare revenue cycle functions is required
• Advanced proficiency in Microsoft Office Suite applications is required especially Excel (pivot tables, advanced formula use, and presentation of data)
• Ability to combine data from various sources for analyzing and reporting
• Demonstrates experience using analytical reporting tools
• Effective critical thinking/problem solving skills with the ability to communicate findings to others verbally and in writing
• Ability to work efficiently and effectively in a fast‑paced environment
• Self‑directed, organizes and prioritizes work and manages multiple tasks and assignments
• Manages time well and performs assigned duties with attention to detail, accuracy, and follow through with minimal supervision while meeting deadlines
• Ability to develop strong working relationships inside and outside the organization
• Experience working with Cerner, Meditech, Athena, eClinical
  
  Works, and/or Fin Thrive suite of tools (Contract Management, Claims Management, Denials Management, Power BI) is preferred