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Revenue Cycle Reimbursement Analyst

3 months ago


Seattle, United States Proliance Surgeons, Inc. Full time
Job DescriptionJob Description

Key Duties and Responsibilities

The key duties and responsibilities of the Revenue Cycle Reimbursement Analyst include, but are not limited to:

  • Identify and address variances using contract discrepancy tools.
  • Appeal bulk variance with payor. Follow-up on appeals until resolved
  • Timely review and resolution of all discrepancies
  • Facilitate resolution of payment discrepancies with payor provider representatives
  • Understand and utilize payor contracts and provider manuals when disputing variances
  • Assist contracting to ensure the fee schedules and contracts are up to date in the contract variance tool.
  • Complete duties and assist others as directed
  • Must follow all policies as introduced during new teammate On-Boarding, updated real-time and outlined in Teammate Handbook

Education/Experience

  • Bachelor’s degree preferred with a minimum of 3+ years healthcare analytical experience.
    • Or 5+ years progressively responsible work experience in patient billing, collections, and claims management
  • Experience with Nextgen and Amkai Billing Systems preferred

Knowledge, Skills and Abilities

  • Thorough knowledge of CPT-4 and ICD-10 coding and RVU based reimbursement methodology and payer contracts
  • Exception communication and conflict resolution skills
  • High level of independence, adaption, and accuracy
  • Strong computer skills including experience in Microsoft Excel, Word, and Outlook
  • Ability to navigate online Payor portals and websites
  • Superior customer service skills
  • Great interpersonal skills; demonstrating patience, composure, and cooperation; working well with all patients, physicians, and staff
  • Understanding of and adherence to all safety, risk management and precautionary procedures, including the consistent respect for confidentiality (HIPAA)
  • Using time efficiently, with meticulous attention to detail, accuracy, and completion
  • Ability to manage multiple factors for the best result
  • Resourcefulness in addressing first level problems and tenacity to see things through to solution
  • Ability to remove oneself personally from given situations, remaining objective
  • Able to adapt to change, delays or unexpected events while maintaining a positive mindset
  • Clear oral and written communication
  • Ability to provide feedback to improve performance
  • Self-motivated; able to work following specific guidelines and in accordance with detailed instructions; measure self against standard of excellence, overcome obstacles and challenges with little supervision.

Work Environment/Physical Demands

The work environment/physical demands described here are representative of those that must be met by a teammate to successfully perform the essential functions of this job. Reasonable accommodations may be made to enable differently abled persons to perform the essential functions.

Work may be performed in an office and clinical environment. Requires corrected vision and hearing to normal range. While performing the duties of this job, the associate is regularly required to talk or hear. The associate is required to sit for long periods of time, stand and walk, bend and stretch. Use of telephone and computer is required. Manual dexterity required for use of computer keyboard. Occasionally lifts and carries items weighing up to 40 pounds. May requires working under stressful conditions or working irregular hours.

Comments

This description is intended to describe the essential job functions, the general supplemental functions and the essential requirements for the performance of this job. It is not an exhaustive list of all duties, responsibilities and requirements of a person so classified. Other functions may be assigned and management retains the right to add or change the duties at any time.