Revenue Cycle Senior Analyst

The Ohio State University

1d • Onsite

About The Position

The Revenue Cycle Process Improvement Systems Analyst serves as an internal consultant supporting and driving implementation of the revenue cycle improvement initiative using a structured industry approved approach. This position is supportive of all revenue cycle process improvement strategic initiatives. The Revenue Cycle Process Improvement Systems Analyst is also responsible for a wide variety of functions that primarily revolve around analyzing and resolving issues with accounts that involve authorization, billing, and compliance. This position serves as an expert in understanding the payers’ requirements and works with various other departments to identify issues and resolve them prior to billing or after a denial is received. This position is responsible for providing a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials. This position analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials. This position uses expert knowledge of payer authorization requirements to write and submit appeals for administrative authorization denials. Identifies and develops appropriate tools to track issues, analyzes workflows, identifies logistical and operational issues to target for improvement. Further, this position is responsible for reviewing accounts with various claim errors that require a second higher-level/comprehensive review. This can include claims with admission or discharge date discrepancies, admission order timing issues, or various other regulatory compliance issues. This position is also responsible for interdepartmental/intradepartmental communication and process improvement throughout the revenue cycle and serve as the primary trainer for onboarding peers with less experience. This position must apply industry knowledge and a thorough understanding of all available systems where revenue cycle information is held, including Midas and EPIC modules for Cadence, ADT, Ambulatory, and Resolute.

Requirements

• Bachelor's Degree in Business or Health Care Administration OR equivalent combination of education and experience
• 2-3 years of operational experience within the Revenue Cycle
• Familiarity with the DMAIC process and lean tools and concepts
• Possess excellent analytical skills
• Good written and oral communication skills
• Possess knowledge of process mapping/value stream mapping tools
• Proficient with computer information systems, preferably Epic, Microsoft Word, Excel, PowerPoint, and Qlik

Nice To Haves

• Master’s degree in business or Operational Efficiency
• Lean/Six Sigma certification and/or experience

Responsibilities

• Serve as an internal consultant supporting and driving implementation of the revenue cycle improvement initiative using a structured industry approved approach
• Support all revenue cycle process improvement strategic initiatives
• Analyze and resolve issues with accounts that involve authorization, billing, and compliance
• Serve as an expert in understanding the payers’ requirements
• Work with various other departments to identify issues and resolve them prior to billing or after a denial is received
• Provide a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials
• Analyze data to identify historic trends, perform comparisons against identified standards, and assist in formulating strategic plans for appealing denials
• Use expert knowledge of payer authorization requirements to write and submit appeals for administrative authorization denials
• Identify and develop appropriate tools to track issues
• Analyze workflows
• Identify logistical and operational issues to target for improvement
• Review accounts with various claim errors that require a second higher-level/comprehensive review, including claims with admission or discharge date discrepancies, admission order timing issues, or various other regulatory compliance issues
• Engage in interdepartmental/intradepartmental communication and process improvement throughout the revenue cycle
• Serve as the primary trainer for onboarding peers with less experience
• Apply industry knowledge and a thorough understanding of all available systems where revenue cycle information is held, including Midas and EPIC modules for Cadence, ADT, Ambulatory, and Resolute

Benefits

• Medical, dental and vision coverage, with Ohio State paying a significant portion of the cost
• Paid time off, including sick and vacation time and 11 holidays
• State retirement plan or an alternative retirement plan, both with generous employer contributions

What This Job Offers

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