Professional Revenue Cycle Analyst

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 professional billing.
  • Assist teams to analyze and present solutions to identified system issues.
  • Analyze and report to the leadership opportunities for system optimization.
  • Ensures system updates are communicated with the departments in timely manner.
• Ensures that the activities of the professional billing teams are conducted in a manner that is consistent with overall department protocol, and are in compliance with Federal, State, and payer regulations, guidelines, and requirements
• Thorough knowledge of billing requirements/regulations of the major third party carriers
• Manages the day to day work flows of the accounts receivable/denial management team, ensuring the reduction of AR days, growth in net collections, reduction in percent of AR greater than 120 days and an increase in cash collected.
• Monitors charge capture work queues, charge posting turn-around times, charge capture reconciliation, as well as reports and metrics. Analyzes trends and follow ups if metrics exceed or fall below baselines.
• Plus all related job duties as assigned

Qualifications

Education, Knowledge, Skills and Abilities Required:

• 5+ years' experience in physician revenue cycle with strong focus on Accounts Receivable and Front End including Registration Denial Management and Account Follow-Up.
• Advanced knowledge of the physician practice operations and revenue cycle managed care issues, revenue cycle and IT Application systems.
• Strong computer literacy including working knowledge of Microsoft office applications (particular depth in Word, Excel, Power Point)
• Candidate should have extensive knowledge of CPT-4, HCPCS, revenue codes, and ICD-10 coding
• Strong customer service and communication skills.
• Excellent problem solving skills and ability to handle multiple tasks.
• Sensitivity to HIPAA and privacy requirements.
• Ability to work independently.
• Ability to assist peers.
• Ability to be detail oriented.
• Ability to work under tight time schedules.
• Ability to communicate verbally and in writing. Qualified candidates must be able to effectively communicate with all levels of the organization.
• Ability to organize information collected from various sources.
• Extensive knowledge of the health care marketplace, financial analysis, current reimbursement issues, budgets and operational analysis.

Education, Knowledge, Skills and Abilities Preferred:

• College degree preferred.

If you feel that the above description speaks directly to your strengths and capabilities, then please apply today

Our Network

Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility

As a courtesy to assist you in your job search, we would like to send your resume to other areas of our Hackensack Meridian Health network who may have current openings that fit your skills and experience.