Revenue Cycle Analyst

Job Description:

Revenue Cycle Analyst:
This job description outlines a role responsible for overseeing a customer’s RCMS contract, ensuring the smooth functioning of the revenue cycle across multiple business accounts, and ensuring key performance indicators (KPIs) are met.

About the Role:
The ideal candidate should have advanced RCM knowledge, problem-solving abilities, and experience in resolving complex customer issues. They will collaborate with teams, lead billing operations, and report monthly performance.

Responsibilities:

• Oversee a customer’s RCMS contract
• Ensure the smooth functioning of the revenue cycle across multiple business accounts
• Ensure key performance indicators (KPIs) are met
• Collaborate with teams
• Lead billing operations
• Report monthly performance
• Responsible for providing oversight of a customer’s RCMS contract
• Ability to address multiple markets of business accounts
• Ensure the revenue cycle is processing appropriately and KPIs are within expected parameters

Knowledge & Application

• Exhibits advanced RCM knowledge
• Possess wide-ranging experience using in-depth professional knowledge, acumen, concepts, and company objectives to develop and resolve complex customer business requirements
• Provides solutions to issues in creative and effective ways, understanding the interrelationships of different EHR functionality and impacts
• Complexity & Problem Solving: Advises on or serves as advisor on complex customer issue analysis that requires evaluation of identifiable factors
• Devises solutions based on limited information and precedent and adapts existing approaches to resolve issues
• Uses advanced knowledge, evaluation, judgment, and interpretation to select the right course of action
• Assesses agency billing requirements, EDI files, and other RCM processes, seeks collaborative solutions, and prepares and presents recommendations
• Resolves concerns with team members with minimal support from leadership to ensure a productive revenue cycle
• Leads an identified effort of complex RCM billing and reporting requirements, seeks collaborative solutions, and prepares and presents recommendations
• Excellent written and oral communication skills
• Ability to think quickly and logically to ensure solutions are identified
• Strong attention to detail and follow-through skills

Duties and Responsibilities

• Maintain & coordinate billing operations and support actions with other team members
• Lead efforts in payer and industry research impacting customers’ businesses
• Coordinate with team members to ensure metrics are met for contracts assigned
• Maintain skills of Senior Billing Specialist; step in and help team members to maintain contractual KPIs
• Monitor accounts for KPI performance and escalations
• Creation of month-end reporting and submission to provider practices
• Assist in process development
• Substantial understanding of medical billing, revenue cycle, and application of knowledge and skills to oversee customer contract(s)
• Identify trends, root causes, and design solutions with minimal leadership support

Qualifications:

• Bachelor’s degree and 6–8 years of medical billing experience
• Excellent Excel skills
• Ability to identify trends and design solutions independently

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.