Associate Analyst, Revenue Operations

Pacific Dental Services - Irving, TX

Full-time - Entry Level

Irving, TX

Ambulatory Health Care Services

About the position

The Associate Analyst, Revenue Operations at Pacific Dental Services plays a crucial role in assisting with production and collections. This position focuses on ensuring that claims are accurately billed to patients and insurance companies, facilitating timely payments, and improving overall revenue operations. The role involves collaboration with various team members to identify opportunities for process improvements and enhance collections efficiency.

Responsibilities

• Assist Analyst, Revenue Operations to 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.
• Assist in identifying strategic financial solutions for Regional Manager (RM) and Operations Manager (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 and present to Collections Analyst II 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 Analyst II, Collections to provide feedback around maximizing the collectable revenue for the region/office.
• Communicate trends and suggestions to improve processes to Collections Analyst II.
• Other duties as assigned by management.

Requirements

• Bachelor's Degree in Finance, Business Administration or related field. In lieu of degree, 1+ years of claims auditing or related 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