Revenue Cycle Analyst II

Vidant Health - Greenville, NC

Hybrid - Greenville, NC

Hospitals

About the position

The Revenue Cycle Analyst II is responsible for creating and running reports related to revenue cycle performance and financial metrics. The Revenue Cycle Analyst II will analyze and aide in optimizing revenue cycle processes. The position will be responsible for evaluating, creating, maintaining and updating system workflows and the departments intranet site. This includes analyzing revenue cycle data, identifying opportunities for improvement, and implementing strategies to increase revenue and improve patient satisfaction. The Revenue Cycle Analyst II will require direct working relationships with management and key staff members in Revenue Cycle.

Responsibilities

• Identify and communicate system issues stemming from billing, edits, rejections, and follow-up work queues with Director and Billing management.
• Independently conduct insightful analysis to investigate trends in write-off data to aid in the identification and prioritization of prevention initiatives.
• Assists in the creation of automation design documents to support business decision-making, process streamlining, automation development, and performance improvement to meet business needs.
• Support in the submission of complex case reviews and appealing surrounding high-priority denials such as auth, medical necessity, COB, etc.
• Support the development, implementation, and evaluation of existing policies and procedures.
• Submit optimization tickets to resolve issues, support in testing and training as necessary.
• Support Rev Cycle management in the preparation of data and strategic opportunities for executive-level audience.
• While Working with the Application Analysts, will thoroughly test and document system upgrades and software modifications.
• Work as a liaison with IS&T and third-party vendors to apply system functionality and upgrades, as well as testing and validation.
• Identify trends; provide documentation, data/reporting to Revenue Cycle Management and owning area key stakeholders, offer suggestions for process improvement, and develop countermeasures in conjunction with operational areas.
• Regularly tracks and analyzes data to identify, recommend, and implement opportunities to secure revenue for the organization; Analyzes and reviews third-party payer medical claims and develops and executes strategies to decrease denials system-wide.
• Identifies trends or patterns that impact payment optimization, and collaborates with departments to establish action plans, initiatives, and policies to reverse negative patterns.
• Researches and analyzes applicable regulatory, coding, and billing rules and educates departments on system application regulations and process requirements.
• Identifies revenue opportunities and provides appropriate investigation, follow-up, and resolution; Analyzes trends and inefficiencies in charges and recommends suitable operational improvements in an effort to prevent incorrect payments and denials.
• Complete monthly standard reports: Parse and share trends and data to operational areas for review on a monthly basis; attend needed follow-up calls for support in operational reviews amongst owning areas.
• Serves as an active team member; participates in department and company-wide initiatives; contributes to the overall culture.
• Maintains tracking documents and dashboards.
• Conduct special projects as needed.
• Perform other related duties as required.

Requirements

• Bachelor's degree or higher in accounting, Finance, Mathematics, Data Science, Statistics or 5+ years of related work experience can be substituted for degree.
• 3+ years of related experience in Revenue Cycle financial reporting in a multi-facility/practice healthcare system.
• 2+ years of demonstrated professional experience in an Analyst role.
• Epic Resolute certification.

Nice-to-haves

• Additional Epic certification in Cadence and Prelude.
• Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare and North Carolina Medicaid reimbursement methodologies.
• Knowledge of third-party payer reimbursement methodologies and contracts.