Associate Revenue Cycle Analyst - Claim Rejections

Job Responsibilities:

• Serves as a source of knowledge for front end billing and claim rejections.
• Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function.
• Assist with developing appropriate workflows and tracking for the designated revenue cycle function.
• Establishes an ongoing working relationship with other departments impacting revenue cycle performance.
• Works closely with the vendor operations teams to oversee operations activities that directly impact the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.
• Tracks outcomes of payment resolution, appeals, and negotiated claims to ensure goals are met.
• Leads weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities.
• Continuously reviews and monitors billing and coding changes, and researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.
• Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.
• Supports goals and metrics to link department and revenue cycle initiatives with the organization's strategy.
• Develops, manages and monitors successful completion of implementation and project plans.
• Acts as an educator on performance improvement requirements in operations and methodologies to related teams and departments.
• Continues to seek new and creative technologies that help identify and guide improvement opportunities that align with overall company success.

Qualifications:

• Bachelors Degree in business or healthcare related field of study preferred.
• At least 2-3 years of experience in medical billing and Insurance collections.
• Basic knowledge of CPT/HCPCS. ICD-10, modifier selection, and UB revenue codes.

Required Knowledge, Skills and Abilities:

• Proficiency with medical billing systems, Microsoft Excel, medical terminology and basic procedure coding knowledge.
• Proficient in spreadsheet development (VLOOKUPS, pivot tables, etc.)
• Knowledge of medical terminology and abbreviations, and health care nomenclature and systems.
• Strong communication (verbal and written), organizational, problem solving and team player skills.
• Ability to navigate across multiple customer demands and balance competing priorities successfully.
• Ability to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner.
• Ability to solve problems using critical thinking skills.
• Maintains confidentiality of sensitive information.
• Analytical skills required.
• Ability to think critically and identify the impact across the revenue cycle with a solution-oriented approach.
• Ability to develop, implement and produce analysis and reports