Revenue Cycle Analyst (On-site)

Full-time - Mid Level

Santa Clarita, CA

Ambulatory Health Care Services

About the position

The Revenue Cycle Analyst at Shield HealthCare is responsible for analyzing the medical claims billing process to identify and resolve payer rejections and denials. This role requires collaboration with various departments to improve internal efficiencies and achieve positive financial outcomes. The position involves creating reports, extracting data, and presenting findings to management, while also managing accounts receivable and potentially supervising a team of billing specialists.

Responsibilities

• Create advanced Microsoft Excel reports/models that highlight reimbursement results and trends
• Gather and extract data from databases using AS400 queries, SQL queries, and Microsoft Power BI
• Utilize trend and comparative analyses to address revenue cycle challenges, looking for ways to solve payer rejections, denials, and underpayments
• Present quantitative and qualitative findings in a clear and concise manner
• Collaborate with staff across the organization to solve problems and improve internal efficiencies
• Establish positive relationships with third-party payers and clearinghouses to resolve billing issues
• Quantify impact of new insurance payer contracts and billing requirement changes
• Handle multiple priorities with aggressive deadlines, ensuring appropriate follow-up and closure
• Prepare variety of ad-hoc reports and analyses as requested
• Evaluate department processes for efficiency and accuracy
• Share responsibility for effectively managing accounts receivable (A/R)
• May be required to supervise a team of claims adjudicators/billing specialists, holding them accountable to achieve positive financial outcomes

Requirements

• Bachelor's Degree in Business/Finance or equivalent work experience
• 3-5 years' experience in an analytical role within finance, claims management, or medical billing preferred
• Familiarity with various medical insurance payer guidelines/billing requirements is a plus
• Proven ability to communicate results of analyses to management with great impact
• Proficiency in Microsoft Office and advanced level of proficiency in Microsoft Excel
• Strong analytical, organizational, and communication skills
• Proven ability to research and solve problems

Benefits

• Medical, Dental, and Vision
• 401(k) with Company Match
• Sick and Vacation Days
• Flexible Spending Account
• Life & Disability Insurance
• Education Assistance
• Employee Referral Program