REVENUE CYCLE ANALYST

Augusta Health

18h • Onsite

About The Position

This position plays a critical role in supporting Augusta Health’s mission and advancing departmental goals through measurable performance indicators and service excellence. This position contributes to a collaborative, patient-centered environment and helps drive outcomes aligned with organizational priorities.

As a Revenue Cycle Analyst, this position performs functions which could include any combination of: daily operations; reporting and analysis; issue identification and resolution; and key performance tracking within the Revenue Cycle of Augusta Health in the areas of revenue integrity; expected reimbursement; and payer monitoring.

Position will begin as onsite with possibility for hybrid or remote eventually.

Requirements

• Education: High School Diploma or equivalent.
• Licensure/Certification: None
• Experience: Minimum of three years of revenue cycle experience.
• Driver’s License: N/A
• Eligibility to work in the United States and meet Virginia state employment requirements
• Knowledge of third party and governmental billing/collection techniques is required.
• Strong and professional verbal and written communication skills are essential.
• Must be able to communicate effectively with all levels of the organization including clinical professionals, co-workers, payer representatives, and practice and hospital administration.
• Must be able to be efficient with multiple computer applications including the health systems HIS system, CMNavigator, Syntellis Contract Management, AccuReg, etc.
• Must be able to work independently and be self-motivated
• Strong ability to use analysis-based problem solving techniques
• Strong time management
• Is considered a subject matter expert.
• Must be extremely organized.
• Must have at least a general understanding of healthcare billing, charge development, and reimbursement processes, as well as healthcare financial management and reporting
• Knowledgeable about healthcare regulatory and compliance issues, particularly in regard to Medicare

Nice To Haves

• Education: None
• Licensure/Certification: Certifications through AAHAM, AAPC, HFMA or other nationally recognized revenue cycle association.
• Experience: None
• Prior experience in a hospital, healthcare system, or related service-oriented environment
• Familiarity with Augusta Health’s systems, workflows, or organizational culture is a plus

Responsibilities

• The incumbent will have a fluid workflow which consists of daily tasks interacting in multiple systems; data analysis regarding charging practices, payer reimbursement, and other revenue integrity initiatives; problem solving and issue resolution.
• The objective of the Revenue Cycle Analyst in support of sound charging practices will be to assure the accuracy and timeliness of patient revenue by maintaining integrity of the CDM and supports the Charge Master Coordinator by: Uploading new charges, price changes and other coding changes into the HIS system
• Interacting with the charge master maintenance software
• Ensuring the legitimacy and compliance of new charge requests
• Ensuring all charge codes are loaded correctly and accurately
• Assisting with the annual charge review performed at the end of each FY in preparation for the next year’s charge structure
• Lead, request, and attend meeting related to charging practices included new services lines, change in services lines, or any other initiative
• Provide information when requested regarding charging activities, revenue and usage, and other charge master data
• Review CPT, HCPCs and Revenue Codes to ensure maintained accuracy
• Develop process documents as needs are identified
• Analyze the impact of regulatory changes and communicate accordingly
• The objective of the Revenue Cycle Analyst in support of tracking and trending of payer reimbursement will be to assure we are receiving the contractually agreed upon payments from our managed care payers by: Maintaining an updated understanding of each of our main payer contracts, including a high level knowledge of payment provisions for high level discussions
• Maintaining an updated understanding of how to access detailed payment provision information for situations where individual claims assessments are needed
• Running and analyzing of payment variance reports from the contract management system
• Monitoring reimbursement of new service lines and locations
• Coordinating corrected payments from payers where variances arise
• Coordinating with underpayment vendor partner on contract questions, coding/billing modifications, potential process improvements
• The objective of the Revenue Cycle Analyst in support of revenue integrity initiatives will be to ensure revenue cycle systems and teams are up to date with payer information by: Maintaining updated payment reference materials including fee schedules, managed care rate matrix, and other rate documents
• Monitoring and updating of the contract management system to ensure AR valuation is as accurate as possible
• Assisting with cataloging of payer contracts
• Supporting patient estimation software with charge and payment updates, troubleshooting individual estimate issues
• Monitoring of payer policy updates, sharing with appropriate Revenue Cycle teams, tracking of needed system/process changes
• Research topics for revenue integrity education and training programs

Benefits

• Comprehensive insurance package including medical, dental, and vision coverage
• Retirement savings plans and financial wellness support programs
• Generous paid time off and flexible scheduling to promote work-life balance
• Career development programs including clinical ladders, shared governance, and advancement opportunities
• Personalized onboarding with dedicated preceptors and ongoing educational support
• Tuition reimbursement and access to onsite childcare
• Free onsite parking, 24/7-armed security for your safety, a Health Fitness Reimbursement Program, and an onsite credit union and pharmacy
• Competitive pay with shift/weekend differentials
• Employee discounts at the cafeteria, gift shop, pharmacy, and local entertainment venues (i.e., movie tickets)

What This Job Offers

• Job Type: Full-time
• Career Level: Entry Level
• Education Level: High school or GED
• Number of Employees: 11-50 employees