Revenue Cycle Mgmt Analyst I

Description

RCM Analyst Level I

Job Description

New Season

Employee Name:_____ Reports to: Director of Payer Relations

Department: Revenue Cycle FLSA: Non-Exempt Direct Reports: 0

Job Summary:

Under limited supervision, this position will support the data needs of the Payer Relations and Revenue Cycle. This position will establish Methasoft payer rate groups, billable services, fee schedules, CPT/HCPCS/ICD10 configurations, and claim formatting; working in collaboration with the core IT Business Applications department. The position will maintain claims data in a HIPAA-compliant format with all content being cross-referenced against other databases to ensure accuracy and consistency.

Essential Functions:

• Facilitates, advises, and provides support to the revenue cycle team in regard to configuration requests.
• Strong data management and computer skills including creating reports, development of spreadsheets, analyzing data, and manipulation of data from multiple data sources.
• Sound data analytics skills including comfort with large data sets, knowledge of common revenue cycle key performance indicators, and attention to detail.
• Strong technical knowledge of revenue cycle operations with the ability to leverage data to identify process improvement opportunities and estimated financial benefit.
• Participates in the design, implementation, testing, enhancement, and RCM configuration.
• Keeps lines of communication open with all external departments to ensure individualized goals are met.
• Adheres to the service policy and principles of CMG/New seasons.
• Other duties as assigned.

Supervisory Responsibilities:

None.

Essential Qualifications:

(To perform this job successfully, an individual must be able to perform each essential duty satisfactorily. The requirements listed below are representative of the competencies (minimum knowledge, skill, and ability) required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions).

Education/Licensure/Certification: This position requires an Associate's Degree in computer science or similar discipline.

Required Knowledge: The candidate will be familiar with healthcare transaction sets including claims, verification, remittance, and authorization. Working with complex software systems, data tables, downloads, and data warehousing, and are critical knowledge bases. Additionally, the ideal candidate will demonstrate the ability to perform testing on records to produce custom output.

Experience Required: Minimum of 1-year healthcare experience working in IT or Revenue Management. Experience working with database systems (i.e. SQL, etc.) and working knowledge of reporting/analytic tools (i.e. Crystal Reports, etc.) preferred.

Skill and Ability: The candidate will demonstrate the ability to work collaboratively and value input from stakeholders within the organization. Requires excellent communication, and analytical, facilitation, and problem-solving skills. Must be a self-directed, strong team player with the ability to establish sound and effective goals and turn them into action. Ability to successfully multi-task and manage workflow priorities. Ability to expand knowledge of various applications and other related tools to maximize potential.

Physical Demands/Work Environment:

(The physical demands and work environment characteristics described here 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.)

Finger Dexterity: Use primarily for writing, operating calculator, telephone, keyboard, and other office equipment.

Talking: To convey detailed or important instructions to employees, patients, and applicants.

Hearing: Ability to hear normal conversations and receive ordinary information.

Vision: Average, ordinary, visual acuity necessary to observe patients and work on the computer. Clear vision at 20 inches or less and distant vision at 20 feet or more.

Physical Strength: Sedentary work; sitting most of the time. Exerts up to 10 pounds of force occasionally.

Working Conditions:

(The working conditions described here 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.)

• Ability to operate in an open work area with moderate everyday noise.

Core Competencies:

_ Analytical Skills

_ Business Acumen/Understanding the Organization

_ Communication

_ Detail Orientation/Attention to Detail

_ Ethics/Values/Integrity

_ Information Gathering

_ Problem Solving

_ Time Management

Mental Activities:

(The mental activities described here 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.)

Reasoning Ability:

Ability to resolve practical problems and deal with a variety of concrete variables in situations where only limited standardization exists. Ability to interpret a variety of instructions furnished in written, oral, diagram or schedule form. Ability to maintain confidentiality.

Mathematics Ability:

Basic mathematics (including statistics) skills required.

Language Ability:

Be able to communicate fluently in English, second language proficiency helpful.

Job or State Requirements

Bachelor's Degree in Finance, Accounting, Business, Data Analytics or related field (hospital/health system required. Minimum of 3 years of experience in healthcare finance, revenue cycle. Experience with computer systems, spreadsheets and data base applications, data flow, report creation and interpretation.