Revenue Cycle Systems Analyst
3 weeks ago
Overview
The Revenue Cycle Systems Analyst is a hybrid position that is responsible for the creation, maintenance and development of all systems, applications and processes within the Revenue Cycle arena. This is a technical position, however, roughly 40% of the job entails workflow shadowing and process improvement efforts that enhance the efficiency of the department.
*May include CDM system management and maintenance; inclusive of the ensuring the Charge Description Master (CDM) is in compliance with hospital coding procedure, departmental processes, and payer regulations; reporting directly to the Chief Revenue Officer.
Responsibilities
Data Integrity
* Serves as a SME and Trainer for super users on revenue cycle applications.
* Demonstrates the ability to troubleshoot and resolve all revenue cycle applications/tools.
* Completes all workflows, interfaces, uses and maintenance for revenue cycle applications.
* Identifies opportunities for optimization.
* Serves as a SME for the revenue cycle.
Communication
* Communicates to all levels of the organization regarding application issues.
* Processes and addresses concerns/issues as it relates to technical or workflow gaps in the revenue cycle.
Project Management
* Demonstrates the ability to manage and complete assigned tasks and projects.
* Collaborates with team members to complete projects and tasks.
CDM Management
* Maintains knowledge of updates and annual maintenance by AMA standards.
* Maintains knowledge of Medicare Ambulatory Payment Classifications (APC) and the Outpatient Prospective Payment System (OPPS).
* Identifies and manages the compliance of charge capture & appropriate CPT assignment under OPPS.
* Collaborates and provides quarterly reports to clinical departmental leaders (nursing, ancillary clinical support staff, etc).
* Attends monthly meetings with the Chief Revenue Officer to review data for those departments that are on the quarterly schedule for each month.
* Responsible for the organizational CDM(s).
* Develops a pricing workflow for departments.
* Follows up with departments regarding job/project expectations and completion.
* Creates a competitive pricing process with finance following established pricing protocol.
* Responsible for the annual maintenance of the CDM.
* Responsible for the business and technology relationship with CDM technology partner(s), including an related applications.
Compliance/Safety
* Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.
* Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility.
* If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.
* Completes all company mandatory modules and required job-specific training in the specified time frame.
* Possesses and constantly develops the knowledge and changes to HCPCS and CPT codes.
Qualifications
Education
High School Diploma or GED- Required
Bachelor's Degree in Computer Science or related field- Preferred
Certification & Licensures
ITIL, Cisco, Cerner certifications- Preferred
Experience
Minimum 2 years experience working in a healthcare IT capacity- Required
Experience working on projects and understanding of the sequence of events that occur prior to completion- Required
1-3 years of showcasing strong technical documentation skills- Required
1-3 years of presenting problems and recommending solutions- Required
Technical troubleshooting experience within a healthcare or clinical setting where the importance of eliminating downtimes are key- Required
Cerner experience- Preferred
Revenue Cycle experience- Preferred
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