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Revenue Cycle Analyst

3 months ago

Valencia, United States Shield HealthCare Full time
Job DescriptionJob DescriptionSince 1957, Shield Healthcare has provided high-quality healthcare services while focusing on customer satisfaction and employee achievement. We are dedicated to fulfilling the medical supply needs of consumers and the caregiving community while maintaining a 99% overall customer satisfaction rating. Over the years, Shield HealthCare has expanded nationally with current service locations in California, Colorado, Illinois, Ohio, Texas and Washington.

Shield HealthCare is looking for a Revenue Cycle Analyst to analyze the medical claims billing process, looking for ways to solve payer rejections and denials. Requires collaboration with cross departmental teams and strong problem solving/research skills. Assists with distributing department workflow, prioritizing projects, and achieving positive financial outcomes.


This is an on-site position in Valencia, CA.


JOB RESPONSIBILITIES:

  • Create advanced Microsoft Excel reports/models that highlight reimbursement results and trends
  • Gather and extract data from databases using AS400 queries, SQL queries, and Microsoft Power BI
  • Utilize trend and comparative analyses to address revenue cycle challenges, looking for ways to solve payer rejections, denials, and underpayments
  • Present quantitative and qualitative findings in a clear and concise manner
  • Collaborate with staff across the organization to solve problems and improve internal efficiencies
  • Establish positive relationships with third-party payers and clearinghouses to resolve billing issues
  • Quantify impact of new insurance payer contracts and billing requirement changes
  • Handle multiple priorities with aggressive deadlines, ensuring appropriate follow-up and closure
  • Prepare variety of ad-hoc reports and analyses as requested
  • Evaluate department processes for efficiency and accuracy
  • Share responsibility for effectively managing accounts receivable (A/R)
  • May be required to supervise a team of claims adjudicators/billing specialists, holding them accountable to achieve positive financial outcomes

QUALIFICATIONS:

  • Bachelor’s Degree in Business/Finance or equivalent work experience
  • 3-5 years’ experience in an analytical role within finance, claims management, or medical billing preferred
  • Familiarity with various medical insurance payer guidelines/billing requirements is a plus
  • Proven ability to communicate results of analyses to management with great impact
  • Proficiency in Microsoft Office and advanced level of proficiency in Microsoft Excel
  • Strong analytical, organizational, and communication skills
  • Proven ability to research and solve problems

PAY & BENEFITS:

  • $35-40/hour
  • Medical, Dental, and Vision
  • 401(k) with Company Match
  • Sick and Vacation Days
  • Flexible Spending Account
  • Life & Disability Insurance
  • Education Assistance

  • Employee Referral Program

Career-minded individuals will find our business challenging and our reputation for excellence just one of the rewards we have to offer. To further enhance this tradition of excellence, our employees participate in continuous training and development programs in a variety of disciplines.