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Aegis Sciences Corporation · 3 months ago

Senior Revenue Cycle Business Analyst

Nashville, TN, US

Full-time

Onsite

Mid, Senior Level

4+ years exp

Aegis Sciences Corporation is a laboratory organization focused on optimizing financial processes. The Senior Revenue Cycle Business Analyst is responsible for analyzing and enhancing patient registration, coding, billing, and collections to maximize revenue and ensure compliance with regulations.

BiotechnologyClinical TrialsHealth CareMedical

Responsibilities

Analyzing denied claims, identifying reasons for denials, and taking corrective actions to minimize future denials

Review medical codes and billing information for accuracy and compliance with billing guidelines to minimize claim rejections and denials

Ensure adherence to healthcare regulations and coding guidelines, including HIPAA and ICD-10 coding standards

Develop and implement strategies to address identified issues, including workflow changes, training programs, and system updates to enhance revenue cycle efficiency

Provide other Revenue Cycle Business Analysts and Specialists one-on-one training/cross training for reviewing and interpreting medical records and internal documentation to enhance appeal strategies

Make informed decisions based on knowledge of Payer policy and knowledge, state and federal guidelines and thorough review of internal documents including the translation of testing protocols and billing and how that impacts the adjudication of a claim to achieve a positive outcome

Collaborate with payers, managed care, clinical and legal to resolve outstanding claims and address billing issues

Analyze large volumes of revenue cycle data, including patient demographics, insurance verification, claim submissions, denial trends, and payment history to identify patterns and areas for improvement

Develop and maintain key performance indicators (KPIs) like days sales outstanding (DSO), denial rates, clean claim submission rates, and collection efficiency to track revenue cycle performance

Analyze and synthesize complex information to identify key issues, develop clear summaries, and define actionable next steps; collaborate across teams to ensure alignment, drive resolution, and maintain momentum on strategic initiatives

Qualification

Denials managementHealthcare Revenue CycleReporting toolsAdvanced Excel skillsInsurance knowledgeCritical thinking

Required

High school diploma or GED required; Degree in Business, Finance or related discipline preferred

With a high school diploma, a minimum of eight (8) years of experience in denials management and other areas of Healthcare Revenue Cycle Functions required; with a Bachelor's degree, a minimum of six (6) years of experience in denials management and other areas of Healthcare Revenue Cycle Functions required; with a Master's degree, a minimum of four (4) years of experience in years of experience in denials management and other areas of Healthcare Revenue Cycle Functions required

Experience using reporting tools and advanced excel skills required

Knowledge of insurance including Medicare, Medicaid, Blue Cross Blue Shield and Third-Party Payers required

Ability to utilize critical thinking skills while performing reimbursement/denial analysis

Company

Aegis Sciences Corporation

Founded in 1990, Aegis Sciences Corporation is a forensic toxicology and healthcare laboratory that provides science-driven drug testing and consulting services based in Nashville, TN.

Founded in 1991

Nashville, Tennessee, USA

501-1000 employees