Revenue Systems AnalystAnderson Hospital
Responsible for implementing and providing support for analytics within the revenue cycle areas, and develops reports with key performance indicators, metrics, and data to support management objectives. Determines how processes can be aligned with best practices to achieve optimal results, measurable change, and a positive financial contribution. Recommends modifications to established practices and procedures or system functionality as needed to support the revenue cycle, and then manages implementation of those changes. The analyst will be very knowledgeable of revenue cycle technology standards, i.e. HL7, 837/835 file formats, 270/271 transactions, etc. The analyst will work with internal customers to ensure implemented workflows and procedures support revenue cycle integrity, and to achieve revenue cycle financial goals. The analyst is responsible for the support and analysis of revenue cycle software, commonly called bolt on technology within Revenue Systems, Patient Access and Patient Financial Services. Also serves as a liaison with the organizations IT department in terms of hospital based information systems that link to revenue cycle departments.
- Generates revenue cycle analytics and monthly reports for management.
- Coordinates and leads new revenue cycle system implementations.
- Serves as an administrator and supports revenue cycle software (i.e. denials, medical necessity, contract management systems). Creates/deactivates users, open cases, data mapping, etc.
- General knowledge of managed care contracts.
- Knowledge of HL7 (ADT, SCH) interfaces and how to read, interpret and troubleshoot data.
- Experience working with 837/835 claims/remit file formats. Ability to read and interpret data.
- To understand how revenue cycle data flows between various systems for troubleshooting purposes.
- Collaborates with other departments to support the processing of financial and patient data.
- Works in a consultative capacity to identify and implement processes, technology and training initiatives. This includes clinical and financial support.
- Documentation of revenue cycle processes and procedures.
- Serves as a resource for revenue cycle staff and assists with problem solving and troubleshooting. Takes initiative with revenue cycle staff to research and resolve problems.
- Investigates denied claims and recommends educational opportunities.
- Experience with writing report queries to pull data lists.
- Knowledge of Medicare reimbursement, i.e. CMS IPPS/OPPS and IRF factors from the CMS website (i.e., DSH, value based purchasing and readmission reduction program).
- Trains staff – new implementations and on-going. Evaluates post-implementation and compliance
- Works as a liaison with IT, troubleshoots scripts, validates data, file transfers, vendor requirements.
- Provides analyst support to the Directors of Revenue Systems, Patient Financial Services and Patient Access.
- Assists in special projects (i.e. lean process improvement) and miscellaneous duties, as assigned.
Education Requirements and Other Requirements:
Education Level: Bachelors - Healthcare Management, Information Technology or similar.
Experience: Minimum of 3-5 years of information/data systems or revenue cycle analytics experience in a healthcare organization. Prefer 5-7 years of experience in healthcare financial and revenue cycle analysis. Clinical knowledge is helpful.
Special Knowledge, Skills, Abilities, Training need to perform the job:
- Strong analytical and organization skills
- Excellent oral and written communication skills
- Ability to multi-task and prioritize workload in a fast-paced environment
- Proficiency in Excel
- Working knowledge of healthcare managed care contracts, and overall revenue cycle management experience