Sr Revenue Cycle Analyst

Children’s Minnesota•USA, MN, MN and WI Remote, MN

About The Position

The Senior Revenue Cycle Analyst supports the revenue management department as a subject-matter 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 and escalate issues within 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 systems.

Requirements

Bachelor’s or associate degree in Healthcare Management, Information Systems, or Business Administration.
5–8+ years of experience in revenue management within a healthcare system, insurance industry, or government organization.
Past system support experience, including requirements gathering and user acceptance testing.
Ability to manage multiple priorities and a heavy workload in a high-stress environment.
Strong time-management, organizational, and self-direction skills; detail orientation and flexibility in an active work environment with changing needs.
High-level problem-solving, analytical, and investigative skills; ability to learn quickly and meet ongoing timelines.
Excellent oral and written communication and customer service 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 excellent service and organizational standards and values, including efficiency, financial responsibility, safety, partnership, 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

Support the revenue management department as a knowledge expert 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 improvements and process reviews, implementing recommended changes using Children’s LEAN methodologies.
Set up, maintain, and upgrade revenue cycle systems.
Gather requirements, support systems, monitor data imports, provide basic system maintenance, document workflows, and coordinate vendor maintenance and escalations.
Develop training documentation and train end users.
Research patient accounts and recreate outcomes.
Project-manage system rollouts; design and test enhancements; prioritize requests; and escalate issues.