Revenue Cycle Analyst

$90,000 - $100,000/Yr

Columbia University - New York, NY

Full-time

New York, NY

Educational Services

About the position

The Revenue Cycle Analyst plays a crucial role in the Faculty Practice Organization by providing comprehensive analytical assessments, reporting, and operational support for various aspects of revenue cycle operations within a central business office. Reporting to the Associate Director of Revenue Cycle, this position is primarily focused on supporting units that manage government, international, and various non-standard third-party accounts receivables. The analyst will engage in a variety of tasks that include reviewing and analyzing Explanation of Benefits (EOBs) and payer correspondences to identify denials that need to be appealed. This role requires a strong understanding of reimbursement analysis, professional billing, medical coding, and payer policies to effectively relay changes in insurance policies to relevant stakeholders. In addition to operational responsibilities, the Revenue Cycle Analyst will participate in training sessions for end-user education and facilitate payer projects to manage bulk appeals. The analyst will oversee various projects as directed by the Associate Director, operationalizing project plans, tracking progress, and identifying areas for improvement. The role also involves preparing presentations for stakeholders and monitoring work queue inventory to identify corrective actions. The analyst will develop new report templates to assist with monitoring revenue cycle metrics and provide assessments focused on process improvement and best practices. The position also includes strategic responsibilities, such as compiling staff productivity and quality assurance statistics, analyzing trends to maximize efficiencies, and presenting data and recommendations to management. Establishing effective collaborative relationships with peers and subject matter experts is essential for resolving issues identified through monitoring key operational indicators. The Revenue Cycle Analyst will represent the CRO Management Team on various committees and task forces, ensuring compliance with HIPAA and billing policies while performing other duties as assigned by the Chief Revenue Cycle Office and Directors of the CRO.

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.
• Apply knowledge of professional billing, payer policies, medical coding, and key contractual terms in performing analysis.
• Participate in training and in-servicing sessions for end-user education within the central business office and service vendor.
• Facilitate and manage payer projects to handle 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 analyze work queue inventory to identify corrective actions and improve logic build.
• 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 and EMR.
• Assist management with obtaining data to support service agreements with external vendors.
• Track performance of external vendor services and resolve 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 manage 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 for various reimbursement concepts.
• Strong knowledge of electronic billing systems and willingness to learn new systems.
• Advanced proficiency in data extractions and use of business analytic applications.
• Demonstrated skills in A/R management, problem assessment, and resolution in complex settings.
• Excellent analytical skills, attention to detail, critical thinking, and decision-making abilities.

Nice-to-haves

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