Revenue Cycle Analyst

$90,000 - $100,000/Yr

The Trustees Of Columbia University In The City Of New York - New York, NY

Full-time - Mid Level

New York, NY

Ambulatory Health Care Services

About the position

The Revenue Cycle Analyst position at Columbia University is a vital role within the central business office, reporting directly to the Associate Director of Revenue Cycle. This position is responsible for providing comprehensive analytical assessments, reporting, and operational support across various aspects of revenue cycle operations. The analyst will primarily focus on managing government, international, and various non-standard third-party accounts receivables, ensuring that the revenue cycle processes are efficient and effective. In this role, the analyst will review and analyze Explanation of Benefits (EOBs) and payer correspondences to identify denials that need to be appealed. They will perform detailed denials analysis to minimize controllable rejections and utilize their knowledge of group payer contracts, payer policies, and member benefits to conduct reimbursement analysis. The analyst will also relay any changes in insurance policies discovered through claim denials to all relevant stakeholders, ensuring that the organization remains compliant and informed. The Revenue Cycle Analyst will participate in training sessions for end-users within the central business office and service vendors, facilitating knowledge transfer and operational efficiency. They will oversee various projects as directed by the Associate Director, operationalizing project plans, tracking progress, and identifying areas of resistance to escalate for mitigation. Additionally, the analyst will prepare presentations for stakeholders and monitor work queue inventory to identify corrective actions, ensuring that the revenue cycle metrics are met and improved upon. This position requires a proactive approach to analyzing productivity and operational performance, assisting management in identifying trends and opportunities for improvement. The analyst will establish collaborative relationships with peers and subject matter experts to resolve issues and represent the CRO Management Team on various committees and task forces. Overall, the Revenue Cycle Analyst plays a crucial role in enhancing the efficiency of revenue cycle operations and ensuring compliance with applicable policies and guidelines.

Responsibilities

• Review and analyze Explanation of Benefits (EOBs) and payer correspondences to identify denials to be appealed.
• Perform denials analysis to reduce controllable rejections.
• Extract and manipulate data using BI tools, Excel, and other query tools within practice management systems.
• Utilize knowledge of group payer contracts, payer policies, and member benefits to perform reimbursement analysis.
• Relay changes in insurance policies discovered by claim denials to all pertinent stakeholders.
• Participate in training and in-servicing sessions for end-user education within the central business office and service vendor.
• Facilitate and work on payer projects to manage bulk appeals with various stakeholders and insurance carriers.
• Oversee various projects as directed by the Associate Director, operationalizing project plans and tracking progress.
• Prepare presentations for various sponsors and stakeholders as needed.
• Monitor and perform analysis on work queue inventory to identify corrective actions.
• Develop new report templates for ad-hoc and standard monthly reports to assist with monitoring Revenue Cycle Metrics.
• Assist with management of user access to various systems such as payer portals, EMR, receivables system, and bank lockboxes.
• Assist management with obtaining pertinent data to support establishing and maintaining service agreements with external vendors.
• Facilitate auditing and processing of vendor invoices for payment.
• Assist with performance tracking of external vendor services and resolving operational issues.

Requirements

• Bachelor's degree or equivalent in education and experience.
• 4 years of related experience, preferably in physician billing and third-party payer reimbursement.
• Advanced skills in using Excel and BI data applications to maneuver through large volumes of data.
• Strong verbal and written communication skills.
• Ability to work independently and handle multiple tasks simultaneously with minimal supervision.
• Proficiency in health insurance billing, collections, and eligibility as it pertains to various reimbursement concepts.
• Strong knowledge of electronic billing systems and willingness to learn new systems and applications.
• Demonstrated advanced skills in A/R management, problem assessment, and resolution.

Nice-to-haves

• Knowledge of Epic PB Resolute is preferred.
• Familiarity with data visualization tools such as Tableau or Power BI.

Benefits

• Health insurance coverage
• Dental insurance coverage
• Life insurance coverage
• 401k retirement savings plan
• Paid holidays
• Flexible scheduling options
• Professional development opportunities
• Tuition reimbursement for further education