Revenue Cycle Analyst
Old Colony Elder Services (OCES) · Brockton, MA · 2 mo ago
FinanceFull-time
What You'll Do
- Steward the granular validation, coding accuracy, and submission lifecycle of complex billing streams to ensure technical compliance.
- Execute forensic, deep-dive audits of unpaid, partial, or rejected claims to isolate technical errors, coordinating immediate corrective action to capture lost revenue.
- Manage technical dispute resolution by functioning as the primary operational link between Senior Care Options (SCO) and One Care plans (OCP), and internal stakeholders.
- Optimize the mechanisms for tracking, invoicing, and capturing SCO and OCP fee balances, mitigating bad-debt risk through systematic and empathetic follow-up.
- Continuously audit electronic data interchange (EDI) logs and member demographic flows to proactively eliminate recursive matching errors between billing networks.
Key Performance Indicators
- Percentage of claims successfully passed and adjudicated on the initial submission pass.
- Average number of business days taken to successfully resolve a flagged claim discrepancy or dispute.
- Days Sales Outstanding (DSO) minimization across SCO and OCP.
What You'll Bring
- Strong analytical and critical thinking skills.
- Excellent Organizational Skills And Attention To Detail.
- Experience With Federal and state contracts.
- Proficient with Microsoft 365 and related software.
- A minimum of Five years of experience.