Sr Revenue Cycle Analyst

Children’s Hospitals and Clinics of Minnesota•MN and WI Remote, MN

About The Position

The Senior Revenue Cycle Analyst supports the revenue management department as a knowledge expert on revenue cycle processes and technology solutions. The role participates in identifying, developing, and executing revenue cycle processes and technology solutions, and collaborates with other departments and external vendors to resolve problems and escalate issues affecting revenue cycle functions. The Analyst assists with process improvements and reviews, implementing recommended changes using Children’s LEAN methodologies. The position is also responsible for setup, maintenance, and upgrades of Children’s revenue cycle.

Requirements

Bachelor’s degree or Associate’s degree in Healthcare Management, Information Systems, or Business Administration.
5–8+ years of experience working in revenue management within a healthcare system, insurance industry, or government organization.
Past system support experience, requirements gathering, and user acceptance testing, including monitoring data imports, providing basic system maintenance, documenting workflows, and coordinating with vendors for maintenance and escalation.
Ability to develop training documentation and train end users.
Ability to research patient accounts within the system and recreate outcomes.
Ability to project-manage system rollouts, design and test enhancements, prioritize requests, and escalate issues.
Strong time management skills and ability to manage multiple priorities and a heavy workload in a high-stress atmosphere.
Detail-oriented, organized, and self-directed, with flexibility to perform other tasks as needed.
High-level problem-solving, analytical, and investigational skills; ability to learn quickly and meet continuous timelines.
Excellent customer service and oral and written communication skills.
Knowledge of third-party payer contract terms and reimbursement methodologies, including DRG, APR DRG, APC, EAPC, fee schedules, modifier reductions, and Minnesota and Wisconsin Medicaid.
Knowledge of healthcare billing system functions, including scheduling, registration, point-of-service collection, charge capture, coding, claim submission, payment follow-up, self-pay collection, and agency placement.
Knowledge of hospital and clinic billing rules, claim edits, modifiers, authorization and certification requirements, CCI edits, and Medicare MUE edits.
Knowledge of HIPAA privacy standards and PCI compliance regulations.
Knowledge of LEAN methodologies and process improvement techniques.
Demonstrates behaviors consistent with principles of excellent service and standards of performance improvement and organizational values, including efficiency and financial responsibility, safety, partnership and service, teamwork, compassion, integrity, trust, and respect.
Proficiency in Microsoft Office products and Visio.

Nice To Haves

System knowledge of Cerner, GE Centricity Business, and eClinical Works.

Responsibilities

Provide expertise and support to the revenue management department on revenue cycle processes and technology solutions.
Participate in identifying, developing, and executing revenue cycle processes and technology solutions.
Collaborate with other departments and external vendors to troubleshoot and escalate revenue cycle issues.
Assist with process improvement initiatives and process reviews, implementing recommendations using LEAN methodologies.
Support system requirements gathering, user acceptance testing, data import monitoring, basic system maintenance, workflow documentation, and vendor coordination for maintenance and escalation.
Develop training documentation and provide training to end users.
Research patient accounts in the system and recreate outcomes.
Project-manage system rollouts, design and test enhancements, prioritize requests, and escalate issues.
Perform system setup, maintenance, and upgrades for the revenue cycle.
Perform other tasks as needed in an active work environment with changing work needs.