Professional Revenue Cycle Analyst

3 weeks ago

Hasbrouck Heights, United States Hackensack Meridian Health Full time

Overview:
Our team members are the heart of what makes us better.

At Hackensack Meridian _Health_ we help our patients live better, healthier lives — and we help one another to succeed. With a culture rooted in connection and collaboration, our employees are team members. Here, competitive benefits are just the beginning. It’s also about how we support one another and how we show up for our community.

Together, we keep getting better - advancing our mission to transform healthcare and serve as a leader of positive change.

The Revenue Cycle Analyst will support the revenue cycle operations by providing expertise in front-end best practice operations, monitor key operational indicators related to cash flow, reconciliation of charges and services rendered, and performs detailed denial analyses including reconciliation of payments at the time of service against posted payments. The Revenue Cycle Analyst will be responsible for overseeing, coordinating, and implementing charge capture initiatives and processes to improve revenue management and revenue protection ensuring the overall integrity of the charge capture process; providing onsite support and assistance for new practices; working directly with HUMG Administrative Directors, Operations Managers and non-clinical staff supporting HUMG doctors' offices on developing and maintaining solvency within each practices revenue cycle. This position performs high level analysis of accounts receivable and uses considerable judgment to determine solution and seeks guidance on complex problems. All tasks must be performed in a timely and accurate manner.

**Responsibilities**:
A day in the life of a Professional Revenue Cycle Analyst with Hackensack Meridian Health includes:

- Responsible for the assessment of front-end operations and subsequent recommendations to improve revenue outcomes, assisting with the identification of front end operation improvements in the Faculty Practices.
- Reviews, monitors, and assists in the explanation of monthly revenue performance against budget and benchmark criteria, prepare revenue analysis in order to maximize reimbursement
- Communicates revenue performance to the department and help in identifying/implementing improvement opportunities.
- Monitors the Ambulatory Open Encounters report to ensure that charges are submitted timely.
- Analyzes billing error and denial data to identify root causes.
- Conducts internal audits and reviews activities to improve the revenue cycle, claims production and coding integrity;
- Analyzes and improves the performance of front-end billing operations through development and monitoring of performance criteria related to;
- Front end patient data acquisition and management;
- Appointment scheduling, patient registration, insurance verification, data entry, charge and diagnosis assignment and charge capture activities;
- Front-end billing operations key indicators, including denial trending analyses and co-pay collection;
- Error reports, claim processing reports, accounts receivable reports and any pertinent ad hoc reports.
- Educates department and related divisions on revenue cycle standards. Provides timely feedback of key performance indicators; training staff on workflows and EPIC Charge and Edit work queues
- Identifies problems in the process flow or organizational structure that impedes financial outcomes, proposes solutions, and collaborates with department to implement corrective action, including;
- Provide onsite support and assistance to assigned practices; observe workflows and assist with the identification of front end operation improvements that will improve the revenue cycle;
- Allocation of resources related to front end function;
- Training of front end staff related to key revenue cycle functions;
- Availability and use of technology and automated tools that support revenue initiatives;
- Enforcement or revision of policies and procedures.
- Performs financial management for the department.
- Monitor the current monthly revenues & communicates results through variance reports.
- Review financial performance through AR analysis and other reports.
- Analyze these variances and identifies opportunities for improved results.
- Performs reimbursement management.
- Analyze payer reimbursement to ensure proper claims adjudication.
- Monitor payment denials, reductions and rejections to determine operational or coding problems.
- Initiates CPT-4 analysis, per provider, to determine shifts in services and payer mix.
- Meets regularly with assigned departments to communicate findings and recommendations to improve revenue management and revenue enhancement
- Utilizes historic and current data to monitor and track performance and trends, and escalates risks and issues in order to improve the business and advance service level agreement commitments
- Responsible for quality AR metrics and creates action plans as needed
- Assists with the ongoing management of EPIC as it relates to

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