Analyst, Revenue Operations

Pacific Dental Services - Irving, TX

Full-time - Entry Level

Irving, TX

Ambulatory Health Care Services

About the position

The Analyst, Revenue Operations at Pacific Dental Services plays a crucial role in enhancing production and collections within the organization. This position involves coaching and training Operation Managers on Accounts Receivable (AR) metrics, ensuring accurate billing to patients and insurance companies, and maximizing collectible revenue. The Analyst is proactive in addressing billing issues and optimizing the collections process across various offices.

Responsibilities

• Maximize office collections, communicate issues and implement guidelines/parameters to improve processes.
• Analyze various internal and external reports to review/trace outstanding and complex claim payments, request additional information from practices, make claim corrections, re-submit, and appeal with carriers for proper payment.
• Identify strategic financial solutions for RM and OM to drive higher percentage of payments, faster billing cycles and top line revenue.
• Analyze the AR Metrics to identify offices that need training or billing process improvements.
• Identify opportunities to work with regions on best practices and more efficient billing processes.
• Perform daily activities of auditing and billing of assigned practice's patient claims to ensure accurate and maximum reimbursement for patient treatment from insurance carriers.
• Analyze Explanation of Benefits (EOB) statements and adjust accounts according to PDS claims processing criteria.
• Identify necessary adjustments to accounts and use negotiation skills to obtain claims approval and payment information from various carriers.
• Review and examine AR Report to ensure accounts are properly billed to the insurance.
• Weekly, check the portals (e.g. Request for Information (RI), and Claims Portal) to ensure that any missing information is obtained, so that the claims are billed properly and claims are properly adjudicated.
• Partner with RM and OM of assigned practices to provide feedback around maximizing the collectable revenue for the region/office.
• Communicate trends and suggestions to improve processes to ROC, OM, and RM.
• Conduct monthly conference calls with RMs and OMs. As well as occasional visits to the region to meet with regional leaders.

Requirements

• Bachelor's Degree in Finance, Business Administration or related field or 2+ years of leading/training individuals on a billing process or 2+ years claims auditing experience is required.
• Experience working with QSI (Quality Systems Inc.).
• Strong computer and data entry skills with competent knowledge of Microsoft Word, Outlook and Excel software applications.

Nice-to-haves

• Previous Operation Management experience in with a retail store or medical/dental practice.
• Insurance Claims Auditing experience.

Benefits

• Medical, dental, and vision insurance
• Paid time off
• Tuition Reimbursement
• 401K
• Paid time to volunteer in your local community