Revenue Cycle Analyst - Transplant (Remote)

$89,600 - $89,600/Yr

Weill Cornell Medicine - New York, NY

Full-time

Remote - New York, NY

Educational Services

About the position

The Revenue Cycle Analyst for Transplant is responsible for managing the claim submission and payment acquisition processes for global transplant package contracts. This role involves overseeing the implementation and management of the Transplant Evaluation program, ensuring compliance with internal and external policies, and improving payment processes. The analyst will also provide training, analyze payment distributions, and recommend strategies to increase revenue through effective claims management.

Responsibilities

• Manage the NYPH Global Transplant Package Program.
• Develop allocation reports of funds and receipts.
• Manage payment posting into the enterprise system.
• Develop ways to improve payment posting/refund processes that comply with internal and external policies.
• Develop internal training sessions for staff on Global Package Program's rules and compliance requirements.
• Responsible for the distribution and account payment reconciliation of the United Resource Network (Optum) program.
• Develop distribution reports to apply payments and create an Optum manual for rules and compliance.
• Administer global package payments for the Gift of Life Program, creating reports for distribution of funds and allocating payments.
• Compile distribution reports, post PKG payments, and reconcile accounts for the Gift of Life Program.
• Educate staff on program guidelines and exclusions.
• Analyze the distribution of the Cigna Life Source PKG case rate for Kidney and BMT admissions.
• Compile distribution reports, post PKG payments, and reconcile accounts for Cigna Life Source PKG.
• Administer data collection and payment posting of the Transplant Evaluation (TE) Program.
• Maintain a database for managing claims/posting process and create charge review and claim edit rules for the program.
• Create training materials and PowerPoint presentations on the Transplant Evaluation (TE) Program.
• Serve as a liaison for departments in understanding program rules and offer suggestions/education on A/R initiatives.
• Conduct ad hoc meetings as needed.
• Make recommendations on increasing revenue through analysis of underpaid and denied claims for the department of Anesthesia.
• Develop and expand practice management tools that expedite identification of underpaid claims.
• Work closely with Managed Care Contracting Office for clarification of contract guidelines and communicate program inconsistencies.
• Offer recommendations to improve business flow.
• Perform other job-related duties as required.

Requirements

• Bachelor's Degree or experience commensurate with job requirement.
• Approximately 5 or more years of prior experience with revenue cycle, managed care contracting, and data analysis.
• Knowledge of automated physician practice management systems.
• Coding knowledge, CPT, ICD10, and modifiers.
• EPIC system experience preferred.
• Demonstrated proficiency with MS Office Suite and database applications.
• Advanced level of communication and interpersonal skills.
• Strong written, verbal, and presentation skills to a wide range of audiences.
• Ability to meet deadlines and work in a high volume work environment.