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 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 non-standard third-party accounts receivables, ensuring that the revenue cycle functions efficiently and effectively. 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 business intelligence tools, Excel, and other query tools to extract and manipulate data from practice management systems. A strong understanding of group payer contracts, payer policies, and medical coding is essential for conducting reimbursement analysis and communicating changes in insurance policies to relevant stakeholders. The analyst will also participate in training sessions for end-users, facilitate payer projects for bulk appeals, and oversee various projects as directed by the Associate Director. This includes developing and executing communication plans, tracking project progress, and identifying areas of resistance. The role requires preparing presentations for stakeholders and monitoring work queue inventory to identify corrective actions. Additionally, the analyst will develop report templates for revenue cycle metrics and assist in managing user access to various systems. Strategically, the analyst will compile staff productivity and quality assurance statistics, analyze trends to maximize efficiencies, and present data-driven recommendations to management. Establishing collaborative relationships with peers and subject matter experts is crucial for resolving issues identified through monitoring key operational indicators. The analyst will also represent the CRO Management Team on various committees and ensure compliance with HIPAA and billing policies. Overall, this position demands a motivated individual with strong analytical skills, the ability to work independently, and a commitment to improving revenue cycle processes.

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, medical coding, and key contractual terms in analysis.
• Participate in training and in-servicing sessions for end-user education.
• Facilitate payer projects to manage bulk appeals with stakeholders and insurance carriers.
• Oversee various projects as directed by the Associate Director, including developing and executing communication plans.
• 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.
• 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 handle large volumes of data.
• Strong verbal and written communication skills.
• Ability to work independently and manage multiple tasks with minimal supervision.
• Proficiency in health insurance billing, collections, and eligibility concepts.
• Strong knowledge of electronic billing systems and willingness to learn new systems.
• Advanced proficiency in data extractions and business analytic applications.
• Demonstrated skills in A/R management and collaborative problem-solving in complex settings.
• Excellent analytical skills, attention to detail, and critical thinking ability.

Nice-to-haves

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