Revenue Cycle Financial Analyst

Position Summary / Career Interest:

The Revenue Cycle Financial Analyst is responsible for identifying, tracking and resolving trends for over and under payments with EMR. This position educates external and internal customers on policies and procedures to improve process flow and decrease denials, over payments and under payments.

Responsibilities:

• Reviews Explanation Of Benefit’s & Remittance Advisement's for denied claims.
• Works with manage care organizations to identify and/or resolve claim submission requirements. Evaluates and resolves issues related to revenue cycle including charge capture, charge master, coding, claim submission or information system.
• Prepares and maintains statistical and financial reports supporting areas of performance improvement. Identifies areas of improvements utilizing financial – statistical indicators related to revenue cycle performance.
• Reviews intradepartmental and interdepartmental processes for improvements that will decrease denials and underpaid claims that occur due to a variety of reasons related to: Authorization, Eligibility, Medical Necessity, Utilization Review, Documentation
• Analyzes situations and makes recommendations that will achieve financial objectives related to revenue cycle.
• Provides training to external and internal customers to educate and improve revenue cycle processes.
• Provides input in analysis of aging trends. Submits ticket requests with Hospital Systems on systems changes to ensure billing accuracy.
• Prepares third party appeals as appropriate.

*Must be able to perform the professional, clinical and or technical competencies of the assigned unit or department.

*Note: These statements are intended to describe the essential functions of the job and are not intended to be an exhaustive list of all responsibilities.  Skills and duties may vary dependent upon your department or unit.  Other duties may be assigned as required.

JOB REQUIREMENTS

Required:

• High School Diploma or GED
• Associate’s Degree in related field, or Associate’s Degree equivalent – 4 years’ experience in claims, denials, chargemaster, coding or insurance processing
• 4 years of experience in financial reporting, processing over and under payments, claims, denials, chargemaster, coding or insurance processing

Preferred:

• Epic experience
• Bachelor’s Degree in related field

We are an equal employment opportunity employer without regard to a person’s race, color, religion, sex (including pregnancy, gender identity and sexual orientation), national origin, ancestry, age (40 or older), disability, veteran status or genetic information.

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