Analyst, Revenue Cycle

Duly Health and Care • Downers Grove, IL

2d • Hybrid

About The Position

The Revenue Cycle Analyst will be responsible for gathering and interpreting data from multiple systems and sources, performing financial modeling of proposed initiatives, and analyzing the financial performance of prior initiatives. This role involves managing revenue cycle programs, creating policies to improve contract performance, and developing financial impact and cost models using various healthcare data. The analyst will translate workflow needs into system requirements for the Technology Team and collaborate with IT/Data infrastructure leads to implement analytics tools, including open-source options like R or Python. Key tasks include creating data tables, validating model results, and developing team members' business knowledge.

Requirements

• Bachelor’s degree preferred.
• Knowledge of healthcare reimbursement methodologies strongly preferred
• A minimum 2 years of healthcare reporting experience
• Prior experience with the health care claims process and electronic claims payment systems such as Epic Tapestry or health plan claims experience
• Industry knowledge of ICD-10, CPT, HCPC coding
• Strong critical thinking and analytical / problem solving skills, comfortable with complex calculations and strong attention to detail.
• Advanced proficiency in Microsoft Office, SQL, and R or Python.
• Exceptional written and oral communication skills
• Understand professional, ancillary and institution medical claims reimbursement methodologies
• Experience working with paid medical claims data
• Demonstrate the ability to deal with the changing environment and to lead/facilitate and manage change efficiently and effectively where appropriate
• Knowledge of healthcare contract provisions and the implications for reimbursement

Responsibilities

• Gathering and interpreting data from multiple systems and sources
• Financial modeling of impact of proposed initiatives and tasks
• Financial analysis of performance on prior initiatives
• Manage revenue cycle programs such as claims projects, patient engagement and contracted rate variances
• Creation of policies to improve contract performance by analyzing denials, underpayments, underperformance of service lines or procedures, physician performance, site level economics and vendor performance
• Develop financial impact and cost models using healthcare claims, EMR data, internal and external referrals, payer contracts, financial class groupings, diagnosis coding on billed and paid claims, to predict financial results from Operations and RCM programs and initiatives. This includes identifying actionable items that would change processes or procedures to maximize performance.
• Translate workflow and best practices into system needs and inputs for Technology Team
• Work closely with IT/Data infrastructure leads to implement tools to develop a flexible analytics environment. Including but not limited to:
• Implement open source tools such as R or Python
• Creating data tables that combine clinical EMR data with paid claims data and demographic information for model building
• Validate model results
• Develop team members’ business knowledge and peer review all results released

Benefits

• Comprehensive medical, dental, and vision benefits that include healthcare navigation assistance.
• Access to a mental health benefit at no cost.
• Employer provided life and disability insurance.
• $5,250 Tuition Reimbursement per year.
• Immediate 401(k) match.
• 40 hours paid volunteer time off.
• A culture committed to community engagement and social impact.
• Up to 12 weeks parental leave at 100% pay and a financial benefit for adoption and surrogacy for non-physician team members once eligibility requirements are met.

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level