Revenue Cycle Vendor Analyst

Jackson Health•Miami, FL

5d•Hybrid

About The Position

The Revenue Cycle Vendor Analyst's primary responsibility will be to ensure that all vendors across revenue cycle department are functioning as expected against the contractual terms. This position will be responsible to manage SLA's, performance metrics and find opportunities for improving an optimizing performance. The role is responsible for ensuring that efforts comply with healthcare regulations (such as HIPAA), align with the organization's financial goals, and optimize the process for patient accounts. The Revenue Cycle Vendor Analyst will analyze vendor performance, resolve disputes, invoice reconciliation, ensure compliance, and work to enhance the overall efficiency of the process. The Revenue Cycle Vendor Analyst is responsible for participation in the analysis, design, implementation, and follow-up of a variety of large-scale revenue cycle projects utilizing computer systems. Participates in all phases of projects, including but not limited to: planning, designing, developing, testing, implementing, training, and troubleshooting. Position requires exercise of independent judgment as incumbents will have access to sensitive and personally identifiable information. Incumbent will also have access to detailed and aggregated revenues, expenses, patient information which must be handled with utmost diligence and high levels of responsibility.

Requirements

Generally, requires 3 to 5 years of related experience.
Familiarity with healthcare financial management systems, patient billing, and insurance verification systems.
Previous experience working with agencies in a healthcare or medical billing environment.
Ability to analyze, organize and prioritize work accurately while meeting multiple deadlines.
Ability to communicate effectively in both oral and written form.
Ability to handle difficult and stressful situations with professional composure.
Ability to understand and follow instructions.
Ability to exercise sound and independent judgment.
Knowledge and skill in use of job appropriate technology and software applications.
Proficiency in MS Office applications, including but not limited to, Excel, Word, PowerPoint, Visio etc.
Knowledge of complex data modeling, data analytics, data querying programs is required.
Valid license or certification is required as needed, based on the job or specialty.
Unit Specific Credential

Nice To Haves

Adequate training will be provided to qualified internal JHS candidates.

Responsibilities

Develop and maintain strong relationships with external agencies, ensuring alignment with the healthcare system's goals.
Serve as the primary point of contact for agencies to resolve issues and ensure ongoing communication.
Responsible for managing the vendor invoicing process, including invoice reconciliation, applying basic accounting principles to ensure accurate and timely payments.
Ensure that agencies comply with legal, regulatory, and contractual requirements, including HIPAA and other healthcare industry standards.
Track and analyze the performance of agencies against defined KPIs (e.g., rates, patient satisfaction, dispute resolution).
Prepare regular reports on the status of performance, identifying trends, opportunities for improvement, and areas of concern.
Ensure agencies are adhering to healthcare regulations and internal policies related to patient data protection, billing, and practices.
Conduct regular audits of vendor operations to ensure compliance with industry regulations and standards.
Analyze data to identify inefficiencies, trends, and opportunities for improvement in the process.
Collaborate with internal stakeholders to prioritize strategies and address delays in the process.
Identifies process improvement opportunities and supports efforts to leverage revenue cycle applications to their fullest potential.
Reviews and analyzes system data and key performance indicators to meet or exceed operational goals.
Supports the development and delivery of user training; assist with development and implementation of strategic goals.
Assists in the implementation of new system software and/or modifications. Participates in all appropriate system installations.
Assists in the management of projects alongside SME's and IT. Analyze changes and enhancements to software in order to determine impacts on existing systems/processes.
Works closely with Patient Access, Case Management, HIM, CBO, Revenue Integrity, and other areas in a consultative capacity to support accurate and timely billing of patient account receivables.
Has a thorough understanding of third party payer requirements for patient services. Interprets data from denials management program to develop denial prevention strategies.
Produces ad-hoc reports and maintains proficiency in understanding revenue cycle workflows; identifies systemic issues and makes recommendations for improvements to the Revenue Cycle leadership team.
Remains current with trends, regulatory requirements, and business strategies related to the revenue cycle.
Represents Revenue Cycle as part of the team that evaluates, tests, and implements custom or vendor supplied business-oriented software according to user specifications.
Maintains a significant level of expertise and proficiency in the utilization of the patient registration, scheduling, clinical and patient accounting systems. Completes assignments within deadlines and works according to project schedules.
Performs all other related job duties as assigned.