Revenue Optimization Specialist - Full Time - Days
About The Position
The Revenue Optimization Specialist is responsible for maximizing revenue from designated payers. This involves creating processes and tools to ensure timely, accurate billing, collections, issue resolution, and payment processing for the assigned payer(s). The Revenue Optimization Specialist focuses on analyzing and improving hospital revenue cycle processes, with an emphasis on collections, revenue optimization, and data-driven decision-making. This role works closely with the business office, coding and leadership to enhance reimbursements and operational efficiency.
Requirements
- Bachelor’s degree in Finance, Healthcare Admin, Business, or a related field is required.
- None.
Nice To Haves
- Advanced excel skills.
- Tablou and PowerBI would be a bonus.
Responsibilities
- Collections Analysis: Monitor and analyze collections data to identify trends, patterns, and areas of concern. Collaborate with the collections team to develop strategies to enhance payment timeliness and reduce aged accounts. Provide recommendations to improve the hospital’s accounts receivable processes, including identifying opportunities to minimize denials and underpayments. Use data analytics to perform root cause analysis of revenue cycle issues and recommend corrective actions
- Collections and Appeals: Contact payors to resolve outstanding claims and expedite payments. Track and submit appeals for denied claims with necessary documentation Investigate reasons for claim denials or underpayments and collaborate with payors to rectify issues. Maintain detailed records of payor interactions, including call logs, emails, and payment outcomes, for reporting and audit purposes.
- Process Improvement: Work closely with the business office team to implement process improvements based on data analysis and findings. Assist in identifying and correcting workflow inefficiencies that may impact the hospital’s ability to collect revenue. Collaborate with finance, billing, coding, and clinical departments to improve revenue integrity and ensure compliance with hospital policies and payer regulations Assist in staff training on billing and collection procedures to ensure adherence to optimized processes
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What This Job Offers
Job Type
Full-time
Career Level
Entry Level
Number of Employees
1,001-5,000 employees
