Revenue Cycle Business Analyst

Highmark Health

1d•$23 - $36

About The Position

GENERAL OVERVIEW: This job conducts insurance billing and follow up functions along with analysis of issues, data reporting, and support of management with business unit needs. ESSENTIAL RESPONSIBILITIES Performs extensive follow-up and collections for third parties, resolving issues that are adversely impacting claims payment. Updates data regarding changes and modifications in plan benefits and other contract information relevant to billing or claims follow up and collection processes. Accurately and completely produces, processes, collects, and/or posts transactions or other designated functions in a timely manner with minimal direction from management. Maintains competency, meets work standards, and maintains proficiency to perform all daily transactions and functions. Maintains data/reporting logs. Collects and maintains data for reporting. Produces professional/publishable views of data/reporting to share with internal and external customers. Plays a key role in maintaining data accuracy. Provides operational support for preparation and maintenance of reports (includes but not limited to month end close, institute reporting/support, ad hoc needs) Coordinates and collaborates with department supervisor, manager, and other departments regularly. Uses problem solving skills and planning abilities to diagnose and solve root process, payer and system issues impacting revenue cycle objectives. Analyzes data and processes; Identifies, quantifies and monitors account detail or workflow processes for barriers. Suggests process improvements and courses of action for problem resolution. Independently leads initiatives as assigned by management, coordinating task teams with department supervisor/manager or other forums to deliver results as identified and/or determined by leadership. Provides formal updates and closure. Conducts problem solving resolution and decision-making sessions for issues and projects. Promotes a culture of performance excellence by enhancing job skills through quality process improvement and tools training/certification; participating in process and operational improvement initiatives; building and maintaining effective relationships throughout organization. Other duties as assigned or requested.

Requirements

Bachelor’s degree in related field or High School diploma/Associate's degree and at least four years of relevant subject matter experience.
5 years of Healthcare experience

Responsibilities

Performs extensive follow-up and collections for third parties, resolving issues that are adversely impacting claims payment.
Updates data regarding changes and modifications in plan benefits and other contract information relevant to billing or claims follow up and collection processes.
Accurately and completely produces, processes, collects, and/or posts transactions or other designated functions in a timely manner with minimal direction from management.
Maintains competency, meets work standards, and maintains proficiency to perform all daily transactions and functions.
Maintains data/reporting logs.
Collects and maintains data for reporting.
Produces professional/publishable views of data/reporting to share with internal and external customers.
Plays a key role in maintaining data accuracy.
Provides operational support for preparation and maintenance of reports (includes but not limited to month end close, institute reporting/support, ad hoc needs)
Coordinates and collaborates with department supervisor, manager, and other departments regularly.
Uses problem solving skills and planning abilities to diagnose and solve root process, payer and system issues impacting revenue cycle objectives.
Analyzes data and processes; Identifies, quantifies and monitors account detail or workflow processes for barriers.
Suggests process improvements and courses of action for problem resolution.
Independently leads initiatives as assigned by management, coordinating task teams with department supervisor/manager or other forums to deliver results as identified and/or determined by leadership.
Provides formal updates and closure.
Conducts problem solving resolution and decision-making sessions for issues and projects.
Promotes a culture of performance excellence by enhancing job skills through quality process improvement and tools training/certification; participating in process and operational improvement initiatives; building and maintaining effective relationships throughout organization.
Other duties as assigned or requested.