Revenue Cycle Analyst

Job Title: Revenue Cycle Analyst

Reports To: CFO

Status: Full Time, Exempt

Job Summary: The Revenue Cycle Analyst will lead system-wide efforts to positively affect Revenue Cycle results. To identify potential areas for improvement and drive system and workflow improvements which can positively impact A/R and ability to collect, the RCA will work with cross-functional teams comprised of facility
management, Financial Planning, IT, Health Information Services, Patient Eligibility and Enrollment, Charge Systems, Contracting, and Patient Accounting. The RCA will provide operational and strategic leadership to task forces to address Revenue Cycle issues/initiatives. The successful RCA will have excellent organizational, analytical, and communication skills with an appreciation for information systems and data and with a commitment to delivering the highest quality of care to our community.

Responsibilities:
• Oversees revenue cycle management for medical, behavioral health and dental services at all IHCSCV sites to ensure timely claim submission and revenue maximization.
• Supervision of daily billing operations; ongoing process improvement analysis; and implementation of system improvements. Oversight includes all activities within
the scope of the Billing Department including coding, charge/data entry, financial counseling, cash posting, insurance follow-up, and billing and collection of patient balances.
• Works with providers, the Operations Department, the Information Services (IS) Department, and contracted technical support staff to ensure integrity and
timeliness of entire revenue cycle.
• Works with IS support vendor on Electronic Data Interchange (EDI) issues and system upgrades to maximize practice management system utilization.
• Maintains regulatory compliance ensuring policies are accurate and up-to-date. Oversees coding staff providing coding assistance to providers and nursing staff.
• Seeks and maintains contracts with public and private insurance companies for all UCNW services including determination of provider eligibility for credentialing.
• Supervises a staff of 10 or more employees.

Qualifications:
• Bachelor’s Degree in business administration or related field required, or equivalent education, training and experience.
• Minimum 3-4 years’ experience in billing, accounts receivable, CPT and ICD-10 coding.
• Minimum two years’ supervisory experience required, preferably in a health care setting.
• FQHC experience required.
• CPT Certification required.

Specialized Skills
& Knowledge:

1. Proven analyst experience and skills.

2. Competency in computerized patient billing systems, Electronic Medical Records (EMR), and other computer software (MS Word, Excel, Outlook).

3. Experience with all phases of third-party billing required. Experience with FQHC-specific billing and reporting requirements a plus.

4. Knowledge of regulations and requirements of Medicare, Medicaid, and private insurance companies.

5. Knowledge of current practices, laws and regulations related to collections.

6. Demonstrated knowledge and experience with CPT/ICD-10 coding.

7. Ability to use office machines (e.g. copy machine, fax machine, credit card machine, telephone, printer, and scanner).

8. 10-key proficiency.

9. Telephone etiquette skills.

Other Qualifications:

1. Ability to effectively communicate, verbally and in writing, with all levels of staff and patients.

2. Ability to leverage resources to resolve issues related to information system utilization, special projects, billing, credentialing, and process improvement.

3. Ability to keep customer service and the mission of the organization in mind when interacting with clients, co-workers, and others, promoting a positive image for
IHCSCV and fostering an ethical work environment.

4. Ability to maintain strict confidentiality with medical information, as well as other confidential information, and conform to HIPAA regulations.

5. Ability to carry out supervisory responsibilities in accordance with the IHCSCV’s policies and procedures and applicable laws.

6. Ability to work both independently and as a team in a fast-paced, medical office environment with frequent interruptions, occasional public contact, and
occasional crisis situations.

7. Must possess strong problem-solving skills and effective time management skills.

8. Must have strong understanding of fiscal, administrative, and clinical systems and the revenue cycle.

9. Ability to read, analyze, and interpret policies, reports, and other documents such as Medicare and Medicaid regulations, FQHC guidelines, and financial statements.

10. Ability to understand and respond effectively and with sensitivity to special populations served by IHCSCV. Special populations include, but are not limited to, those defined by race, ethnicity, language, age, sex, sexual orientation, economic standing, disability status, migrant, homelessness, seasonal workers, and the
uninsured.