Senior Business Analyst - Financial Revenue

$94,000 - $129,000/Yr

Vancouver Clinic - Vancouver, WA

Full-time - Senior

Onsite - Vancouver, WA

Ambulatory Health Care Services

About the position

The Senior Business Analyst for Revenue is a pivotal role within our organization, responsible for developing and reporting proactive business intelligence that supports decision-making in contract reimbursement, revenue cycle management, budgeting, and project management. This position is not remote and is based in Vancouver, WA. As a lead analyst, you will mentor peers and provide insights into healthcare industry reimbursement forecasts while continuously scanning the financial environment for changes that may impact the organization. Your expertise will be crucial in ensuring that our financial strategies align with industry standards and regulations. In this role, you will perform both quantitative and qualitative analyses, build contract models, and assist the underpayment team in detecting system problems. You will also be responsible for reviewing and auditing claim payments to ensure that payor contract implementations are accurate. Maintaining the integrity of the Charge Master (CDM) is essential, and you will oversee routine monthly audits to ensure compliance with payor requirements. Additionally, you will manage pricing changes at the beginning of the fiscal year and as dictated by circumstances, ensuring that our pricing strategies are competitive and compliant. Your in-depth knowledge of revenue cycle processes will enable you to provide consultation on the design of business processes, specifying the necessary outputs, required inputs, and methods of validation and quality control. You will be responsible for the annual budget figures related to fee schedules, proposed pricing analysis, payor contractual allowances, and the application of Federal Regulatory CMS proposed fee schedule and reimbursement updates. By identifying pricing and payor contracting opportunities, you will play a key role in positively impacting the organization's bottom line.

Responsibilities

• Perform and assist with quantitative and qualitative analysis.
• Build contract model and assist underpayment team to detect system problems and recommend viable solutions, interim alternatives, and documentation of processing irregularities.
• Review and audit claim payments to ensure payor contract implementation is correct.
• Maintain and ensure the overall integrity of the CDM (Charge Master) with a focus on accuracy, revenue cycle integrity, and compliance with payor requirements, including overseeing routine monthly audits of the CDM.
• Maintain pricing changes at the beginning of the fiscal year and as dictated by circumstances.
• Maintain a working knowledge of revenue cycle processes to provide consultation on design of business processes, specifying the needed output, the required input, and the methods of validation and quality control for compliance with billing guidelines.
• Display in-depth knowledge of various components of medical revenue and the impact of those on reported financial statements including budget modeling.
• Responsible for the annual budget figures in regard to fee schedules, proposed pricing analysis, payor contractual allowances, and application of Federal Regulatory CMS proposed fee schedule and reimbursement updates.
• Identify pricing and payor contracting opportunities to positively impact the bottom line.

Requirements

• Bachelor's degree in Accounting, Finance, Business Analytics, Healthcare Administration, or other healthcare-related field.
• Medical Billing knowledge required.
• CPC preferred or similar coding certification.
• 5+ years' experience in Revenue Cycle processes required.
• Revenue management experience required.
• Financial or Revenue Analyst experience demonstrating strong financial modeling and data analysis skills including revenue budget variance analysis with a thorough understanding of revenue budget drivers.
• Technical aptitude and advanced experience with data tools, such as SQL and Tableau.
• SQL queries experience preferred.
• Certifications desired in the following Epic applications: Resolute PB, Cogito Revenue Data Model or Cogito Fundamentals.
• Must achieve certification in at least one Epic application within the first 2 years of employment.

Nice-to-haves

• Experience with healthcare financial regulations and compliance standards.
• Familiarity with advanced data visualization tools beyond Tableau.