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The Revenue Cycle Management Analyst is responsible for working collaboratively with Revenue Cycle Management staff and Leadership in the area(s) assigned, assisting with analysis of Epic System build and workflow processes, as well asassisting in coordination of daily operations. Maintains working knowledge of the Revenue Cycle, including Governmental Reimbursement, Managed Care Contracting & Analysis and the performance of the Business Office, PreServices, & Registration areas. Collaborates with other departments such as HIM, Outcomes Management/Utilization Review, and Reimbursemtn/Finance as needed. 

• Understands all revenue cycle processes across FirstHealth entities (e.g., Pre-Services, Registration, Charge Entry, Coding, Billing, Collections, Denials).

• Compiles and organizes information for presentation to management with analysis and recommendations.

• Identifies and reports unusual trends; investigates and proposes improvements.

• Assists in charge structure and coding reviews to ensure regulatory compliance and proper service charges.

• Reviews failed claims and coordinates corrections with appropriate personnel.

• Monitors CMS and payer websites for updates affecting billing and reimbursement.

• Educates and shares relevant updates with staff.

• Understands managed care and government reimbursement performance.

• Researches root causes of denials and supports corrective action planning.

• Maintains professional appearance and demeanor in all interactions with employees, applicants, and visitors.

• Assists with the Hospital Financial Audit.

• Supports management with special projects as needed.

• Serves as a liaison between the managers, Finance, Business Office and Compliance on billing and charging issues

Bachelor's degree in Accounting, Finance, or Healthcare administrative field preferred (a combination of

experience and education will be considered in lieu of a degree). One to three years in healthcare financial

analytics or hospital /professional billing experience is preferred. Experience with commercial and

governmental payers is preferred. Must possess strong Microsoft Excel and analytical skills. Certified

Professional Coder certification is preferred.

Additional Skills: 

• Knowledge of CPT-4, HCPCS, UB-04, HCFA 1500 and ICD-10 Coding as well as OPPS & CCI

edits. Ability to work independently, exercising sound judgement, discretion and initiative.

• Leads meetings and workgroups. Influences and contributes to strong sense of teamwork and

collaboration.

• Knowledgeable in EPIC and other patient financial/accounting systems.

• Proficient in using personal computers and Microsoft Office products.