Acclara Careers

Description

Job Title:                      Analyst, Revenue Cycle Performance

Company:                    Tegria Revenue Cycle Management (Tegria RCM)

Department:                 Ops/Analytics

Leader:                           Sr. Director, Revenue Cycle Services

FLSA Status:                 Salaried/Exempt

Work Location:            Remote within U.S.

Travel:                            Minimal (5%)

Compensation:              $41,600.00 - $83,000.00

OVERVIEW

The Revenue Cycle Analyst is responsible for collaborating with our payers and clients, analyzing, communicating, and presenting AR payer trends and to ensure proper execution of client contracts to assure maximum amount of reimbursement is achieved. Additionally, the Analyst will have direct communication with the payers and our client for all payer projects relating to Accounts Receivable. 

Responsibilities include:

• Analyze A/R and financial reports identifying payer trends to report to clients
• Remittance analysis providing payer trends and potential contractual allowances
• Analyze denial trends which impact the cash flow.
• Develop and deliver presentations to our clients /providers highlighting current projects and payer trends that are impacting the receivable.
• Evaluate payer trends to the internal leadership to assure the charges are set up appropriately per the contract. Report any findings to management for resolution.
• Collaborating with the Follow-Up team any claim payment issues should be identified promptly and maintained on a project template which will be sent to the insurance carrier monthly
• Research and resolve all on-going payer issues via appropriate contacts/parties at the insurance company. Utilization of all insurance-provided tools for greater and more efficient collection activity.
• Maintain updated knowledge of third-party requirements/guidelines. This requires knowing all updates to all payer contracts, coding, and specs
• Manage the implementation of revenue cycle projects to communicate and resolve payer issues that directly impact the AR. Develop and maintain schedule for project completion that effectively allocates the resources to the activities review and revise schedule as required
• Manage the customer and internal resources and expectations to drive toward project milestone and overall project execution
• Manage the objectives and measures upon which the project will be evaluated at its completion
• Responsible for targeting completion of process improvement projects within a specified time frame while achieving a cost reduction goal
• Set up files to ensure that all project information is appropriately documented
• Monitor the progress of the process improvement project and adjust as necessary to ensure the successful completion
• Schedule and facilitate regular status meetings as well as facilitate information to keep teams well informed of changes, client requests within the organization and other related issues
• Establish a communication schedule to update client and carriers including appropriate staff in the organization on the progress of the project
• Assist in achieving buy-in from all decision makers for the successful application of performance excellence / performance improvement. Assist in creating team processes for optimizing results
• Assist in leading projects and provide individual contributions after key projects have been identified
• Ensure that the project deliverables are on time, and at the required level of quality
• Delivers engaging, informative, well-organized presentations
• Other duties as assigned

• Bachelor’s degree or equivalent education and experience
• 3+ years of relevant revenue cycle experience
• Knowledge of EOBs, CPT, and ICD-9 codes, HCFAs, UB04s, HCPCS, DRGs and authorizations/referrals
• Proficiency in using Microsoft Office applications (e.g., Word, Excel, PowerPoint and Outlook
• Full understanding of healthcare revenue cycle operational and billing processes, customer service, project management and training
• Excellent leadership, in negotiating, influencing, conflict resolution, research, and analytics
• Professional communication and presentation skills in order to be client facing
• Customer focused, and results driven effectively collaborating with various levels throughout the company
• Strong interpersonal skills and ability to work cross-functionally with leaders on sensitive/emotional issues
• Work within ambiguous, fast-moving environment, while also driving toward clarity and resolutions
• Resourcefulness in setting priorities and guiding investment in people and systems
• Knowledge of basic statistics, comparative analysis. Ability to solve complex, analyze unique problems
• Resourcefulness in setting priorities and guiding investment in people and systems
• Be motivated, self-starter, organize/manage multiple tasks concurrently, perform with limited supervision
• Experience identifying user needs and developing training strategies, and related courses/materials
• Ability to communicate sensitive information tactfully and diplomatically internally and externally
• Persuasive communication skills, both oral and written, and strong interpersonal skills
• Prior experience writing complex standards for application to multiple stakeholders

Preferred Qualifications:

Experience in insurance, collections and/or training

Physical Requirements:

The physical demands described are representative of those that must be met by an employee to successfully perform the essential functions of this job.  Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.  Listed below are the physical requirements required while performing the duties of this job.

• The employee is regularly required to: stand; sit; talk; hear; use hands and fingers to operate a computer and telephone keyboard; and reach, stoop and/or kneel to install computer equipment
• The employee must have the specific vision ability to complete close vision requirements due to computer work
• The employee is required to be able to complete light to moderate lifting

Our Commitment to Diversity, Equity, and Inclusion:

We welcome and respect the variety of experiences, viewpoints, and cultural backgrounds that everyone brings to our workplace. Tegria RCM makes every effort to promote a workplace where leaders model inclusive behaviors and individuals feel respected, valued, and empowered.  Together, we promote and sustain an inclusive workplace where people feel a sense of belonging