Xtensys · 5 days ago
Revenue Cycle Quality Analyst
Ithaca, NY
Full-time
Onsite
Mid Level
3+ years expXtensys is a managed service provider delivering technology to health systems, and they are seeking an experienced Revenue Cycle Quality Analyst to join their team. The analyst will perform quality assurance reviews across revenue cycle workflows to ensure standards are met and collaborate cross-functionally to maintain quality metrics.
Health CareHospital
Responsibilities
Compile productivity data for employees subject to QA review and prepare regularly scheduled management reports with actionable recommendations
Validate productivity measurements and continuously monitor the effectiveness of production standards
Conduct scheduled reviews of accounts and all activities related to claim resolution
Perform routine reviews of business unit processes to identify errors, training needs, and system enhancement opportunities
Audit third-party partners and vendors as needed
Complete QA analysis of claims processing, follow-up, and denial workflows using established audit tools
Review, respond to, and resolve quality audit inquiries, including disputed findings
Perform routine system and process testing as requested by Revenue Cycle or operational leadership
Prepare and submit monthly QA evaluation reports with detailed and summary findings
Identify, document, recommend, and track resolution of process gaps and best-practice improvements
Compute and report statistical QA data, identifying trends and patterns with accuracy
Maintain deep knowledge of insurance follow-up, denials systems, and revenue cycle policies and workflows
Perform other duties as assigned
Qualification
Required
Minimum of 3 years of hospital revenue cycle experience
Strong knowledge of the managed care industry, including payer structures, administrative rules, and government payers
Comprehensive understanding of revenue cycle functions including patient access, billing, reimbursement, cash posting, collections, denials, and guarantor collections
Proficient knowledge of medical coding systems impacting claims adjudication, including ICD-9, CPT, HCPCS, DRG, APG, APC, and revenue codes
Strong analytical, investigative, and problem-solving skills
Ability to work independently and collaboratively in a team environment
Exceptional attention to detail with the ability to prioritize and meet deadlines
Effective written and verbal communication skills
Proficiency in Microsoft Excel, Word, and PowerPoint
Adaptability and ability to respond quickly to change
Associate's degree with 3 years of revenue cycle experience required, OR
High school diploma with 5 years of revenue cycle experience required
Preferred
3 years of quality or audit experience preferred
Benefits
Competitive salary
Comprehensive benefits
Career development pathways
Company
Xtensys
Xtensys Connected Health Solutions to demonstrate our unique approach to building and supporting advanced applications.
201-500 employees
Funding
Current Stage
Growth StageCompany data provided by crunchbase