Revenue Cycle Analyst

Penn Medicine - West Chester, PA

Full-time - Entry Level

West Chester, PA

1,001-5,000 employees

Ambulatory Health Care Services

About the position

The Revenue Cycle Analyst at Penn Medicine plays a crucial role in ensuring effective revenue management and protection through collaboration with various teams. This position involves tracking charge initiatives, conducting audits, and managing denials to optimize revenue opportunities. The analyst will work closely with internal and external clients, contributing to the overall efficiency of the revenue cycle process.

Responsibilities

• Assist in coordinating charge description master and charge capture initiatives.
• Update, coordinate, and monitor denials management via Cobius system, including reporting and appealing accounts.
• Create and run reports analyzing RAC and commercial denial trends for presentation at Revenue Cycle Team meetings.
• Assist with annual CDM reviews and charge capture education.
• Support the revenue integrity manager with communication and information flow.
• Oversee daily charge reconciliation of assigned departments.
• Gather data and reports for internal and external audits.
• Assist with internal audits and EPIC edits, ensuring billing compliance.
• Coordinate with outreach physician practices for updated education and training on medical necessity.
• Assist with charge entry verification and coding reviews for accuracy and compliance.
• Conduct hospital audits and provide analytics of outcomes with action plans for corrective measures.
• Assist in the review of external audit requests and coordinate the audit process.
• Gather documentation and respond to denials, downgrades, or DRG changes.
• Assist patients with billing concerns and clinical complaints.
• Proactively inform the Revenue Cycle Manager of any issues or concerns.
• Participate in setting the tactical and strategic vision for the Revenue Cycle area.
• Collaborate with Financial Counselors and self-pay patients to determine cost of care.
• Work with the Corporate Compliance/HIPAA Privacy Officer on incident investigations.

Requirements

• Bachelor's degree or Master's degree (preferred); equivalent combination of education and experience.
• 1-2 years' progressive experience in hospital functions including coding, reimbursement, compliance, and billing.
• Knowledge of hospital information and coding systems, including M/ICD-10-CM, CPT, and HCPCS.
• Ability to work collaboratively with all levels of the organization and manage conflicts.
• Knowledge of compliance concerns related to coding, billing, reimbursement, and documentation.
• Strong interpersonal, verbal, and written communication skills.
• Strong organizational and time management skills.
• Solid analytical and problem-solving skills.
• Ability to handle recurring problems and work under pressure with changing priorities.
• Intermediate skill in personal computers and proficiency in Microsoft Applications.

Nice-to-haves

• Professional certification within 12 months of employment (AAHAM, HFMA, AAPC).

Benefits

• Tuition reimbursement
• Comprehensive compensation and benefits program
• Prepaid tuition assistance program