Technical Analyst - Revenue Cycle and Claims

Delivery Multiple, United States


Description

Technical Analyst - Revenue Cycle and Claims  
Job Summary:
  • Works with stakeholders to discover, clarify, and document current and future data needs
  • Performs mapping of revenue cycle, clinical and claims data to a normalized data model.
  • Serves as a subject matter expert on the revenue cycle data domains such as Registration, Scheduling, Accounting and Billing, Cost Accounting and Claims
  • Builds data concepts to support Revenue Cycle and Claims use cases
  • Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.
 
Responsibilities:
  • Act as a quality consultant and subject matter expert, performing testing and validation of the mapping of data elements to standards
  • Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues
  • Works with customers to clarify and plan for their current and future technology needs. Determines and maps existing business processes/functions and recommends changes required to fit a tightly integrated system.
  • Designs and implements projects requiring systems integration, small teams and multiple technical platforms.
  • Conducts Return on Investment (ROI) and other financial analysis to support project funding/prioritization.
  • Collaborates on driving improvement activities to achieve department and organizational goals.
  • Coordinates with functional team to assure consistency and optimization of overall work product
  • Assumes a proactive role in driving improvement activities to achieve department and organizational goals to deliver value.
  • Maintains current knowledge of industry and business process trends and is able to apply that knowledge to existing business processes.
  • Provides subject-matter expertise of Health Ministry processes, policies and requirements in support of functional area process design, testing and implementation
  • Identifies opportunities for process improvement and makes recommendations that lead to improvements
  • Monitors task assignments to ensure they are performed on schedule, within intended scope and to a defined level of quality.
  • Escalates process and project issues that cannot be resolved
 
Experience:
  • Prior experience working as a Revenue Cycle analyst in the Healthcare system.
  • Must have a working knowledge of relational databases/database structures, SQL expertise desired
  • Must have a strong understanding of data collected and used in EMRs, Revenue Cycle and Patient Accounting Systems.
  • Knowledge and experience with ambulatory and acute clinical, billing and claims workflows and clinical information systems.
  • Bachelor or Masters degree in related health or finance field ex informatics or bioinformatics.
  • Complexity of work: Within the scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment.
  • 5 years of experience preferred