Revenue Cycle Operations Analyst

Mecklenburg EMS Careers•Charlotte, NC

3d•Onsite

About The Position

The Revenue Cycle Operations Analyst is responsible for the timely and accurate processing of all data files for various areas including Daily Import, TriZetto files, Debt Set off, Collection Agency, and other established outside vendors. This role involves producing weekly and monthly department reports on staff production and AR performance, identifying areas for correction, and implementing approved resolutions to optimize performance. The analyst will perform data analysis to extract requirements, identify data inaccuracies, and ensure accurate processing and reporting. They will also develop data collection methods, coordinate participant tests, and serve as a process/functional representative for new processes and problem resolution. A key aspect of this role is understanding and communicating the process implications of revenue cycle challenges and managing potential problems from a process perspective until resolution. The analyst will act as a subject matter expert on project teams, meeting deadlines, and occasionally leading projects. They will maintain a working knowledge of CMS regulations, third-party payors, and insurance law changes, performing compliance audits and follow-up evaluations to ensure consistent performance and improvement. The position requires strong analytical, interpersonal, customer service, communication, and problem-solving skills, along with proficiency in various computer applications. The analyst will also provide application support, troubleshoot problems, and demonstrate the Business Office Core Values. Coordination of Tritech Billing software updates, end-user testing, and identifying training needs are also part of the responsibilities. This includes analysis, design, and development of revenue cycle reports, updating the patient accounting database, and resolving discrepancies. The role requires advanced knowledge and serves as a subject matter expert, providing backup for various roles as needed. Creating and presenting onboarding, orientation, and skills training for employees, as well as updating department policies and procedures, are also key duties.

Requirements

Five years of Revenue Cycle experience required.
Strong analytical and problem-solving skills.
Prioritize assignments and manage multiple deadlines.
Provide high-quality output with minor input from leadership.
Ability to work in a team environment.
Ability to work independently to complete assigned duties.
Proficiency with all Microsoft Office Suite programs, proficiency with Revenue Cycle software solutions, Local debt set-off programs such as Five-Star Computing, Revenue Recovery programs such as Solutions Group, File Transfer Protocol, Minitab, and Business Intelligence tools such as Tableau.

Nice To Haves

Bachelor’s in healthcare administration or accounting preferred
healthcare administration analytics experience preferred

Responsibilities

Responsible for all data files processing in a timely and accurate manner for the following areas: Daily Import, TriZetto files, Debt Set off, Collection Agency, and other established outside vendors.
Responsible for production of weekly and monthly department reports, including staff production and AR performance with the ability to identify areas of correction, and to then establish and implement a management approved resolution supporting optimal performance.
Performs data analysis to extract requirements, identify data inaccuracies, and to ensure accurate processing and reporting.
Develops data collection methods and strategies for data management, coordinates participant tests and procedures.
Participates in the identification, justification and articulation of need for improvement efforts.
Serve as a process/functional representative to establish new processes and/or resolve problems.
Lead the effort to understand and communicate process implications of the revenue cycle challenges.
Organize the effort to manage the potential problems for the process perspective until resolution.
Works effectively as a department and agency subject matter expert on project teams, meeting deadlines in accordance to project manager's expectations; on occasion may serve as project lead when appropriate.
In-depth knowledge of ambulance medical billing and procedures; and submission of insurance claims.
Understands and has experience with all functions of healthcare revenue cycle, with the ability to apply specific methodologies for desired outcomes, to include EMS claims billing for government and commercial payors.
Maintain a working knowledge of CMS regulations, third party payors, and changes to insurance laws, with the ability to perform compliance audits.
Routinely perform follow-up evaluations of data to ensure consistent organizational and individual performance and improvement.
Provides application support and troubleshoot problems when they arise to support department operations.
Demonstrate the Business Office Core Values of integrity, teamwork, dedication, quality, decision-making, communication, and creative thinking.
Coordinates and maintains Tritech Billing software updates with Department Supervisor, as well as end user testing to identify appropriate training and education needs for the department.
Assessment may be done through surveys, interviews, focus groups and communication with managers, instructors and customer representatives.
Analysis, design and development of revenue cycle reports.
Includes compiling, creating and analyzing weekly and monthly department reports for Finance and Finance Committee such as finance run charts and third-party denials from third party payers.
Update patient accounting database and resolve discrepancies, serving as support for revenue cycle staff with process and technology initiatives.
Demonstrates advanced knowledge and serves as subject matter expert for all areas of the department, serving as back-up within various roles to maintain production standards when needed.
Create, organize, plan and present various forms of onboarding, orientation and skills training for employees.
Present training and development programs using various formats, while maintaining knowledge of the latest trends.
Create, organize and update department policies and procedures periodically and as necessary.