Revenue Cycle Analyst
About The Position
CareDx, Inc. is a leading precision medicine solutions company focused on the discovery, development, and commercialization of clinically differentiated, high-value healthcare solutions for transplant patients and caregivers. CareDx offers products, testing services, and digital healthcare solutions along the pre- and post-transplant patient journey, and is the leading provider of genomics-based information for transplant patients. The primary responsibilities of the Revenue Cycle Analyst include identifying opportunities to maximize collections by analyzing payer denial trends and performing root cause analysis to identify areas of improvement. This position also involves reporting analyzed KPIs to the Revenue Cycle, Finance, and Market Access departments, and producing accurate and timely standardized and ad-hoc analysis related to insurance reimbursement outcomes. This role requires detail-oriented work, knowledge of root cause analysis, and the ability to interpret reporting results to multiple audiences. Candidates must thrive in a fast-paced environment with the ability to operate independently and take initiative. This is a full-time position, Monday through Friday. Candidates within commuting distance of the Brisbane, California office will need to come to the office on a regular basis; remote candidates will work and collaborate from home.
Requirements
- Bachelor’s degree in quantitative field required.
- Advanced knowledge of Microsoft Excel and experience with data tools (SQL, Tableau, Power BI, Looker)
- 2+ years of experience in Revenue Cycle, Billing or related experience required.
- Working knowledge of ICD-10, CPT, and HCPCS coding, DSO reductions, accounts receivable, HIPPA, authorization process, and contracting.
- Ability to prioritize and manage multiple concurrent tasks.
- A collaborative and proactive problem-solver with exceptional communication and interpersonal skills with excellent time management.
Responsibilities
- Perform root cause analysis to identify trends related to denials and rejections, authorization outcomes, and reimbursement issues. Develop a data-driven plan to partner with management in executing reimbursement resolution strategies.
- Produce monthly KPIs and required month end reporting. Identify payers and reasons for changes.
- Proactively identify reimbursement opportunities.
- Accurately produce and analyze ad-hoc data requests to stakeholders and management within Revenue Cycle – Billing and Authorization functions, Finance, and Market Access.
- Confidently identify bottlenecks within the reimbursement process to reduce DSO, decrease accounts receivable, improve success of appeals and records, and increase collections.
- Assist management and team with tracking action plans to ensure timely collections and timely follow up.
- Creatively utilize dashboards via established platforms (Tableau/SQL/PowerBI) and advanced excel to visually represent data and statistically determine reimbursement expectations and effectively communicate improvement suggestions to stakeholders.
- Develop dashboards and standardized reporting utilizing data tools which could include, but not limited to: Payer score cards, work queue prioritization and reporting, A/R and adjustment research, bulk collection dashboards, and system maintenance.
- Identify gaps and areas of improvement in analytics capabilities and work with technical teams and Business Intelligence Analyst to implement enhancements that improve denial and reimbursement issues identification.
- Assist with PAMA reporting for all required tests and other state required reporting functions with accuracy and timely delivery.
- Develop a thorough understanding of systems, processes and payer-specific reimbursement processes and billing requirements, assisting in the proactive identifications of opportunities for Revenue Cycle improvement.
Benefits
- Competitive base salary and incentive compensation
- Health and welfare benefits, including a gym reimbursement program
- 401(k) savings plan match
- Employee Stock Purchase Plan
- Pre-tax commuter benefits
- Living Donor Employee Recovery Policy that allows up to 30 days of paid leave annually to a full-time employee who makes the selfless act of donating an organ or bone marrow.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
