Revenue Cycle Business Analyst

This position acts as the liaison between the department and billing office for professional billing. Responsibilities include but not limited to professional billing support revenue analysis adhoc reporting creating/finetuning workflows troubleshooting billing errors/denials new business/projects and work queues.

Department Support and Monitoring Revenue Cycle Business Analysts meet with department customers and evaluate professional billing performance. Maintain current understanding of department business operations. This includes a knowledge of all eligible billing providers associated CPT codes clinical billing workflows and thirdparty claim requirements. Conducts thorough review of department financial workflows and provides recommendations as needed; assist providers staff and /or carriers in resolving billing reimbursement and compliance issues; run ad hoc data queries and recurring financial reports of average to high complexity; develops queries/reports for distribution to others; facilitate monthly financial meetings; prepare reports agendas and action items as appropriate; analyze and explains financial variances; escalates concerns and identifies opportunities to improve billing performance and reimbursement; evaluates findings and prepares recommendations for department staff; research and develop new procedures policies and workflows to improve billing and reimbursement and decrease denials; present timely updates on regulatory changes that impact billing rules and requirements including Federal and State regulations and carrier policies; helps facilitate annual code updates and physician documentation education; assists with annual wRVUs and fee schedule updates.

Program Coordination Provides professional billing expertise through coordination of business partners engaged in program activities including but not limited to ITG coding compliance managed care contracting and legal; participates in projects impacting revenue cycle operations and completes new business checklist when applicable; supports long term department objectives short term financial goals and provides recommendations based on in depth knowledge of program service offerings; monitors department charges for accuracy; ensures program coding and billing compliance; interprets governing rules and regulations; and conducts financial meetings. Analysts work with insurance carriers on payor medical policies and help resolve billing/payment discrepancies.

Professional Billing Office Representation Represents the professional billing office and helps explain and interpret operations or policies; represents professional billing in department committees and to individual department staff and providers. Designs develops and presents (or coordinates the presentation of) professional financial data.

Miscellaneous May require coordination with Epic Resolute Systems team to ensure technical build in place to meet departmental billing needs. May also include updates to work queue rules or department approved blanket authorizations. Analysts responsible for submitting and tracking change requests and communicating changes and fixes to department staff. Responsible for communicating revenue cycle updates with department leadership and ensure timely information provided as needed. Identifies operational strengths and weaknesses problems or areas of noncompliance and recommends corrective action. Also responsible for helping facilitate provider enrollment tasks.

Participate in Revenue Integrity projects as directed by the Revenue Cycle Business Analysts Manager Revenue Integrity Assistant Director and/or Revenue Integrity Director.

• Bachelor degree in Health Care Administration or Business Administration or equivalent combination of education and experience.
• Four or more years experience in a health care medical billing and/or insurance environment.
• Experience with health care billing operations including knowledge of payer denials denial management managed care contract policies and HIPAA regulations.
• Strong analytical skills to drive improvement in departments revenue cycle.
• Public speaking skills and the ability to present detailed financial information.
• Must be able to work with a diverse team and customer base under strict confidentiality and deadline pressures.
• Advanced multitasking and organizational skills; excellent communication both written and verbal and listening skills are required.
• Proficiency with standard office equipment and software including Microsoft Office Suite. High aptitude in Microsoft Excel.
• Knowledge of Health Information Systems including Epic billing system and reporting software such as Business Objects or Webi.

• Masters in related field
• 3 years recent experience working for an Academic Medical Center