Revenue Cycle Process Improvement Systems Analyst

About the role

The Revenue Cycle Process Improvement Systems Analyst serves as an internal consultant supporting and driving implementation of the revenue cycle improvement initiative using a structured industry approved approach. This position is supportive of all revenue cycle process improvement strategic initiatives.

Responsibilities

• Analyzing and resolving issues with accounts that involve authorization, billing, and compliance
• Working with various other departments to identify issues and resolve them prior to billing or after a denial is received
• Providing a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials
• Analyzing data to identify historic trends, perform comparisons against identified standards, and assist in formulating strategic plans for appealing denials
• Writing and submitting appeals for administrative authorization denials
• Identifying and developing appropriate tools to track issues, analyzing workflows, identifying logistical and operational issues to target for improvement
• Reviewing accounts with various claim errors that require a second higher-level/comprehensive review
• Interdepartmental/intradepartmental communication and process improvement throughout the revenue cycle
• Primary trainer for onboarding peers with less experience
• Using expert knowledge of payer authorization requirements
• Thorough understanding of all available systems where revenue cycle information is held, including Midas and EPIC modules for Cadence, ADT, Ambulatory, and Resolute

Requirements

• Bachelor's degree or equivalent experience
• Advanced degree in relevant field may be desirable
• 4 years of relevant experience required
• 4-8 years of relevant experience preferred