The Revenue Cycle Analyst (RCA) understands healthcare delivery in a patient care setting. Able to articulate information, utilize an analytical approach to data, and be a team player who understands the power of data in driving a successful revenue cycle. The RCA will coordinate with interdisciplinary teams to create end to end solution for quality improvement.
Must be able to learn quickly, work independently, and is relentless in overcoming technical, process, and organizational obstacles. The RCA will be responsible for empowering others with data across the institution, providing a unique blend of revenue cycle, technical, and analytical expertise. The RCA will work with multiple groups within the organization to improve operations.
The RCA is able to combine revenue cycle knowledge with technology to empower decision makers and show how analytics and data can improve outcomes, optimize processes, and reduce costs. The RCA exhibits creative problem solving techniques and can work within a collaborative team towards a common goal. The RCA analyst will function as an internal consultant for process and quality improvement projects.
The individual will need to build relationships with key stakeholders, be an expert in multiple data sources, and implement sustainable solutions. POSITION REQUIREMENTS Minimum
None Minimum Work
Three (3) years in hospital revenue cycle operations or healthcare technology related field. One (1) year of experience in healthcare analytics. Required Licenses/Certifications: None
, Knowledge, and Abilities: Good understanding of patient accounting and medical charting preferred. Ability to interpret and generate written correspondence utilizing proper grammar, spelling, and composition skills. Computer knowledge required.
Experience with automated systems required. Ability to operate office equipment, such as copy machines, fax machine and printers. Must be able to work independently with minimal supervision.
Good verbal and written communication skills essential. Prior experience involving public contact. Preferred Qualification: None JOB SPECIFIC FUNCTIONS 1.
Demonstrates an understanding of and adherence to the HMHD Compliance Plan. 2. Conduct reflects HMHD's values and a commitment to HMHD's Code of Conduct. 3. Attends the required corporate integrity and compliance training and education programs. 4.
Demonstrates proficiency in understanding the materials presented during the corporate integrity and compliancetraining and education program. 5. Complies with all HIPAA standards. 6. Analyze data to assist revenue cycle leaders in revenue cycle management. 7.
Captures key performance indicators and other suggestions for improvement and decision support. 8. Reports key statistical data regarding metrics, and assist with actionable work plans and recommendations around revenue cycle improvements. 9. Works closely with stakeholders from different functional units on topics, including billing, charge capture, coding, and edit/denial management. 10.
Prepares detailed reports as needed to assist leaders in cash and AR reporting. 11. Assist each Collector and Biller/Collector with difficult accounts to expedite payment resolution and/or appeal timelines. 12. Coordinate system functional and user acceptance testing. 13.
Assist in new employee system training. 14. Participate in system user and internal team meetings. 15. Function as a liaison between Information Technology, systems vendors and Revenue Cycle departments. 16.
Provide systematic ongoing support to numerous hospital management teams. 17. Coordinate various aspects of project implementations, systems upgrades and quality assurance processes. 18. Calculates A/R > 90 days in age per Collector and Biller/Collector on monthly basis. 19.
Electronic Posting Process- Monitors eClaims posting and serves as back up, if needed. 20. Electronic Lockbox system- Healthlink Recon & Research. 21. Maintains RAC request & reconciliation to General Ledger. 22.
Completes 835 Applications to ensure electronic receipt of payments. 23. Completes programing in Meditech for eClaims. 24. Support others when questions and/or concerns about responsible areas are expressed. 25.
Works in tandem with staff as well as other departments. 26. Reviews and interprets Federal and Fiscal Intermediary guidelines and mandates. Shares data with appropriate personnel. 27.
Complete the ATB audit process on insurance/new topics and to assist with prioritizing accounts Biller/Collector, when requested. 28. Perform special duties and projects as assigned. 29. Completes research and troubleshooting as needed. 30.
Assist with root cause analysis when errors and trends are noted. 31. Maintains assigned B/AR dictionaries, when required. 32. Serves as a liaison between hospital and billing vendor. 33.
Enter accurate and thorough comments on patient accounts. 34. Assist with the claims Rejection list on a routine basis. Educates staff as needed. 35.
Assist with the gathering data and the coordination of efforts when audit request are received (i.e. Internal or External audits, Medicare, Medicaid etc..). 36. Serves as Secretary of the Denial Management Committee. 37.
Present research or project summaries to Manager, Director or appropriate Denial and PI Committees when requested. 38. Assist to provide continuous education to ancillary departments. 39. Resolve issues and/or concerns amicably in a timely manner. 40.
Involves PFS Leader when needed. 41. Take corrective action to resolve charge errors (i.e. corrections, data extraction, education). 42. Serve as a resource for others within the District. 43.
Assist manager, director and CFO upon request. 44. Work within multiple systems (i.e. contract management software, HIS, scanning, etc.) while meeting production, financial, and quality goals. 45. Promote and demonstrate excellent customer service at all times with internal and external customers to include patients, physicians, co-workers and all other customers. 46.
Communicates effectively and expresses ideas clearly, actively listens and follows appropriate channels of communication. 47. Adaptable and responsive to change. 48. Uses time clock accurately and is punctual on a consistent basis. 49.
Demonstrates a positive attitude in all assigned task and towards others. 50. Follows "Call-In" policy by notifying PFS Leader of absence. 51. Absences during evaluation period: 0-6 Occurrences = Meets Requirements. 7 or more Occurrences = Does not meet requirements. 52.
Adheres to hospital and department dress code. Maintains a professional appearance at all times. 53. Consistently contributes to the achievement of excellence in healthcare through the quality and caring values of the mission and vision of Hunt Memorial Hospital District.