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NorthBay Health · 2 months ago

Revenue Cycle Management Analyst III

4500 Business Center Drive, Fairfield, CA, 94534, US

Full-time

Onsite

Mid Level

NorthBay Health is a healthcare organization seeking a Revenue Cycle Management Analyst III to support revenue cycle operations. The role involves ensuring efficient workflows, managing revenue and charges, and providing analytical support regarding payer reimbursement contracts.

Health CareHospitalMedical

Responsibilities

Coordinates with other departments including finance, decision support, business office, etc., to develop and generate reporting templates for monitoring and troubleshooting revenue performance

Assist in development and maintenance of revenue cycle reports, dashboards, and key performance indicators (KPI)

May work collaboratively with the appropriate operational leaders to develop provider education strategies to promote complete and accurate clinical documentation and correct negative trends and is able to impart this knowledge to provide and other health team members

Support revenue cycle staff and supports revenue cycle teams as needed

Works with managed care and reimbursement departments to respond to strategic initiatives to optimize patient revenue capture

Review payments for accuracy from contracted payers and management of appeals process with each assigned payer, in both the hospital and clinic setting

Performs contract and reimbursement variance analysis

Performs related administrative duties to ensure the effectiveness and optimum maintenance of the applications

Supports management of projects and workflows reengineering

Runs, reviews, interprets, analyzes and validates Revenue Cycle reports

Possesses the ability to run Revenue Cycle and operations reports in order to answer questions from department/practice managers, physicians, and other Revenue Cycle stakeholders

Takes an active role in new service research and assessment

Assists in quantifying audit outcomes, including revenue realized

Plays a key role in the creation of training manuals and job aids for respective area(s) of expertise

Develops, recommends, and implements new programs and projects as directed by the Revenue Cycle leadership team

Researches, works with large sets of data, reviews, interprets, and follows all relevant policies, procedures, regulations, guidelines and laws and attend mandatory training

Participates in regularly scheduled department meetings, as well as training seminars or sessions as assigned

Plans, organizes and prioritizes workload and processes information at a speed necessary for successful job performance

Adhere to the department’s rules, guidelines, and procedures for lunch and break times, requesting time-off and changes in shift assignment

Is thoroughly familiar with the hospitals facility-wide policy and procedures manuals, the department’s policy and procedure manual and the facility’s fire and safety, as well as emergency preparedness processes and procedures

Communicates in a calm, courteous, and professional manner with co-workers, outside organizations, representatives, or business entities

Other duties as assigned

Maintains a strong working knowledge of all departmental systems, policies, procedures and their impact on other departments

Qualification

Revenue Cycle ManagementAnalytical SkillsProject ManagementData AnalysisReporting SkillsCustomer ServiceCommunication SkillsProblem-Solving

Required

Supports revenue cycle operations to ensure efficient workflows, management and monitoring of revenue, charges, and revenue cycle internal and external customers to ensure established goals are met while adhering to federal and state regulations, policies of external payers, coding rules and guidelines

Exercise independent decisions using analytical and problem-solving skills

Provides critical analytical and negotiation support with respect to third party payer reimbursement contracts

Works closely with the analysts in the other Revenue Cycle Management Departments to ensure effective workflow and process

Maintains strong working knowledge of operational policies and procedures related to accounts receivable management

Responsible for evaluating, recommending and assisting with implementation of systems solutions to enhance the automation of accounts receivable management

Performs audits designed to ensure integrity, quality and control over the billing processes

Assists with training and education on the information systems functionality and billing and coding practices

Works independently, manages multiple priorities, and demonstrates strong analytical and customer service skills

Ability to communicate complex information to front-line staff, department leaders, and executives while maintaining professionalism and accuracy

Technical resource, point of contact, and key participant from RCM to develop, test, train, implement and maintain the software associated with departmental functions, including conversions and upgrades

Assists with planning, execution and finalizing projects and utilizes project management tools, process and methodologies within budget and deadlines

Works independently on implementations and A/R systems development to accommodate the addition of key systems service lines

Responsible for planning, developing, training, implementation, and evaluation of information systems to support ongoing operations and ensure development, evaluation, and ongoing support for all components of Revenue Cycle

Ensures the accurate flow of data and communication regarding ambulatory revenue

Works to ensure financial systems and report systems are coordinated relative to data quality, efficiency and data integrity

Coordinates with other departments including finance, decision support, business office, etc., to develop and generate reporting templates for monitoring and troubleshooting revenue performance

Assist in development and maintenance of revenue cycle reports, dashboards, and key performance indicators (KPI)

May work collaboratively with the appropriate operational leaders to develop provider education strategies to promote complete and accurate clinical documentation and correct negative trends

Support revenue cycle staff and supports revenue cycle teams as needed

Works with managed care and reimbursement departments to respond to strategic initiatives to optimize patient revenue capture

Review payments for accuracy from contracted payers and management of appeals process with each assigned payer, in both the hospital and clinic setting

Performs contract and reimbursement variance analysis

Performs related administrative duties to ensure the effectiveness and optimum maintenance of the applications

Supports management of projects and workflows reengineering

Runs, reviews, interprets, analyzes and validates Revenue Cycle reports

Possesses the ability to run Revenue Cycle and operations reports in order to answer questions from department/practice managers, physicians, and other Revenue Cycle stakeholders

Takes an active role in new service research and assessment

Assists in quantifying audit outcomes, including revenue realized

Plays a key role in the creation of training manuals and job aids for respective area(s) of expertise

Develops, recommends, and implements new programs and projects as directed by the Revenue Cycle leadership team

Researches, works with large sets of data, reviews, interprets, and follows all relevant policies, procedures, regulations, guidelines and laws and attend mandatory training

Participates in regularly scheduled department meetings, as well as training seminars or sessions as assigned

Plans, organizes and prioritizes workload and processes information at a speed necessary for successful job performance

Adhere to the department's rules, guidelines, and procedures for lunch and break times, requesting time-off and changes in shift assignment

Is thoroughly familiar with the hospitals facility-wide policy and procedures manuals, the department's policy and procedure manual and the facility's fire and safety, as well as emergency preparedness processes and procedures

Communicates in a calm, courteous, and professional manner with co-workers, outside organizations, representatives, or business entities

Maintains a strong working knowledge of all departmental systems, policies, procedures and their impact on other departments