Revenue Cycle Analyst

Penn Medicine - West Chester, PA

Full-time

West Chester, PA

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 by collaborating with various teams to track charge initiatives and conduct audits. This position involves direct interaction with internal and external clients, focusing on charge capture, denial management, and compliance with billing regulations.

Responsibilities

• Assist in coordinating charge description master and charge capture initiatives.
• Update, coordinate, and monitor denials management via Cobius system, including the outpatient RAC program and commercial carriers.
• Create and run reports analyzing RAC and commercial denial trends, presenting findings at Revenue Cycle Team meetings.
• Assist with annual CDM reviews and charge capture education.
• Support the revenue integrity manager with communications and information flow.
• Oversee daily charge reconciliation of assigned departments.
• Gather data and reports for internal and external audits, including EPIC edits and WQ ownership.
• Assist with medical necessity coordination and education for outreach physician practices.
• Verify charge entry and conduct coding reviews for accuracy and compliance.
• Assist in conducting hospital audits and provide analytics based on audit findings.
• Coordinate external audit requests and monitor the audit process.
• Assist in gathering documentation for denials and billing concerns from patients.
• Proactively inform the Revenue Cycle Manager of any issues or concerns.
• Participate in setting the tactical and strategic vision for the Revenue Cycle area.
• Work closely with Financial Counselors and self-pay patients to determine cost of care.
• Collaborate with the Corporate Compliance/HIPAA Privacy Officer on incident investigations.

Requirements

• Bachelor's degree or Master's degree (preferred) or 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.
• Understanding of Charge Description Master content, structure, and maintenance.
• Ability to work collaboratively across all organizational levels and manage conflicts.

Nice-to-haves

• Professional certification within 12 months of employment (AAHAM, HFMA, AAPC).
• Strong interpersonal, verbal, and written communication skills.
• Solid analytical and problem-solving skills.
• Ability to handle and resolve recurring problems.
• Proficiency in Microsoft Applications and intermediate skills in personal computers, email, and internet.

Benefits

• Comprehensive compensation and benefits program.
• Prepaid tuition assistance program.