Revenue Cycle Analyst - Transplant (Remote)

$89,600 - $102,800/Yr

Weill Cornell Medicine - New York, NY

Full-time

Remote - New York, NY

Educational Services

About the position

The Revenue Cycle Analyst - Transplant is responsible for managing claim submissions and payment acquisition for global transplant package contracts at Weill Cornell Medicine. 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 work closely with various departments to enhance revenue through effective claims management.

Responsibilities

• Manages the NYPH Global Transplant Package Program.
• Develops allocation reports of funds & receipts.
• Manages payment posting into the enterprise system.
• Develops ways to improve payment posting/refund processes that comply with internal & external policies.
• Develops 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.
• Develops distribution reports to apply payments and creates and maintains an Optum manual for rules and compliance.
• Administers global package payments for the Gift of Life Program, creating reports for distribution of funds & allocating payments.
• Compiles distribution reports, posts PKG payments & reconciles accounts, educating staff on program guidelines & exclusions.
• Analyzes the distribution of the Cigna Life Source PKG case rate for Kidney and BMT admissions generated from the Managed Care Contracting office.
• Administers data collection and payment posting of the Transplant Evaluation (TE) Program, maintaining a database for managing claims/posting process.
• Creates training materials and PowerPoint presentations on the Transplant Evaluation (TE) Program.
• Serves as a liaison for departments in understanding program rules and offers suggestions/education on A/R initiatives.
• Makes recommendations on increasing revenue through analysis of underpaid and denied claims for the department of Anesthesia.
• Works closely with Managed Care Contracting Office for clarification of contract guidelines and communicates programs' inconsistencies.
• Performs 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 high volume work environment.