Senior Revenue Cycle Business Analyst and Team Lead

Aegis Sciences Corp • Nashville, TN

93d

About The Position

The Senior Revenue Cycle Business Analyst and Team Lead is responsible for analyzing and optimizing the financial processes within a laboratory organization, including patient registration, coding, billing, and collections, by reviewing data to identify trends, areas for improvement, and implementing strategies to maximize revenue while ensuring compliance with regulations, ultimately improving the overall revenue operations experience. They will also supervise Revenue Cycle Specialists and Business Analysts.

Requirements

• High school diploma or GED required; Degree in Business, Finance or related discipline preferred
• With a high school diploma, a minimum of ten (10) years of experience in denials management and other areas of Healthcare Revenue Cycle Functions required; with a Bachelor’s degree, a minimum of seven (7) years of experience in denials management and other areas of Healthcare Revenue Cycle Functions required; with a Master’s degree, a minimum of five (5) years of experience in years of experience in denials management and other areas of Healthcare Revenue Cycle Functions required
• Experience using reporting tools and advanced excel skills required
• Knowledge of insurance including Medicare, Medicaid, Blue Cross Blue Shield and Third-Party Payers required
• Ability to utilize critical thinking skills while performing reimbursement/denial analysis

Responsibilities

• Supervise Revenue Cycle Specialists and Business Analysts
• Analyze denied claims, identifying reasons for denials, and taking corrective actions to minimize future denials
• Review medical codes and billing information for accuracy and compliance with billing guidelines to minimize claim rejections and denials
• Ensure adherence to healthcare regulations and coding guidelines, including HIPAA and ICD-10 coding standards
• Develop and implement strategies to address identified issues, including workflow changes, training programs, and system updates to enhance revenue cycle efficiency
• Provide other Revenue Cycle Business Analysts and Specialists one-on-one training/cross training for reviewing and interpreting medical records and internal documentation to enhance appeal strategies
• Make informed decisions based on knowledge of Payer policy and knowledge, state and federal guidelines and thorough review of internal documents including the translation of testing protocols and billing and how that impacts the adjudication of a claim to achieve a positive outcome
• Collaborate with payers, managed care, clinical and legal to resolve outstanding claims and address billing issues
• Analyze large volumes of revenue cycle data, including patient demographics, insurance verification, claim submissions, denial trends, and payment history to identify patterns and areas for improvement
• Develop and maintain key performance indicators (KPIs) like days sales outstanding (DSO), denial rates, clean claim submission rates, and collection efficiency to track revenue cycle performance
• Analyze and synthesize complex information to identify key issues, develop clear summaries, and define actionable next steps; collaborate across teams to ensure alignment, drive resolution, and maintain momentum on strategic initiatives

What This Job Offers

• Career Level: Senior
• Education Level: Bachelor's degree
• Number of Employees: 501-1,000 employees