Revenue Cycle Analyst II
2 days ago
ECU Health
About ECU Health Medical Center
ECU Health Medical Center, one of four academic medical centers in North Carolina, is the 974-bed flagship hospital for ECU Health and serves as the primary teaching hospital for The Brody School of Medicine at East Carolina University. ECU Health Medical Center has achieved Magnet® designation twice and provides acute and intermediate care, rehabilitation and outpatient health services to a 29-county region that is home to more than 1.4 million people.
Position Summary
The Revenue Cycle Analyst II is responsible for creating and running reports related to revenue cycle performance and financial metrics. The Revenue Cycle Analyst II will analyze and aide in optimizing revenue cycle processes. The position will be responsible for evaluating, creating, maintaining and updating system workflows and the department's intranet site. This includes analyzing revenue cycle data, identifying opportunities for improvement, and implementing strategies to increase revenue and improve patient satisfaction.
The Revenue Cycle Analyst II will require direct working relationships with management and key staff members in Revenue Cycle.
Responsibilities
- Identify and communicate system issues stemming from billing, edits, rejections, and follow-up work queues with Director and Billing management.
- Independently conduct insightful analysis to investigate trends in write-off data to aid in the identification and prioritization of prevention initiatives.
- Assists in the creation of automation design documents to support business decision-making, process streamlining, automation development, and performance improvement to meet business needs.
- Support in the submission of complex case reviews and appealing surrounding high-priority denials such as auth, medical necessity, COB, etc.
- Support the development, implementation, and evaluation of existing policies and procedures.
- Submit optimization tickets to resolve issues, support in testing and training as necessary.
- Support Rev Cycle management in the preparation of data and strategic opportunities for executive-level audience.
- While Working with the Application Analysts, will thoroughly test and document system upgrades and software modifications.
- Work as a liaison with IS&T and third-party vendors to apply system functionality and upgrades, as well as testing and validation.
- Identify trends; provide documentation, data/reporting to Revenue Cycle Management and owning area key stakeholders, offer suggestions for process improvement, and develop countermeasures in conjunction with operational areas.
- Regularly tracks and analyzes data to identify, recommend, and implement opportunities to secure revenue for the organization; Analyzes and reviews third-party payer medical claims and develops and executes strategies to decrease denials system-wide.
- Identifies trends or patterns that impact payment optimization, and collaborates with departments to establish action plans, initiatives, and policies to reverse negative patterns.
- Researches and analyzes applicable regulatory, coding, and billing rules and educates departments on system application regulations and process requirements.
- Identifies revenue opportunities and provides appropriate investigation, follow-up, and resolution; Analyzes trends and inefficiencies in charges and recommends suitable operational improvements in an effort to prevent incorrect payments and denials.
- Complete monthly standard reports: Parse and share trends and data to operational areas for review on a monthly basis; attend needed follow-up calls for support in operational reviews amongst owning areas.
- Serves as an active team member; participates in department and company-wide initiatives; contributes to the overall culture.
- Maintains tracking documents and dashboards.
- Conduct special projects as needed.
- Perform other related duties as required.
Minimum Requirements
Required Education/Course(s)/Training:
Bachelor's degree or higher in accounting, Finance, Mathematics, Data Science, Statistics or 5+ years of related work experience can be substituted for degree.
3+ years of related experience in Revenue Cycle financial reporting in a multi-facility/practice healthcare system
2+ years of demonstrated professional experience in an Analyst role.
Required Certification/Registration
Epic Resolute certification
Skill Set Requirement:
Knowledge of third-party application integrations (supply chain, transcription, productivity tools, general ledger, and other revenue cycle management vendors)
Skilled in gathering and documenting user requirements, performing design/build.
Testing scripts and performing ongoing maintenance and support.
Skilled in supporting Epic module implementations, optimization, and troubleshooting.
Advanced proficiency with Microsoft Excel, Microsoft Word, and Microsoft Access.
Demonstrated time management skills and ability to handle multiple priorities with shifting time frames and meet deadlines.
Strong organizational skills with the ability to work on multiple, complex projects with high quality results.
Understanding of Medical terms and acronyms
Reasoning skills and ability to articulate logic behind decisions.
Excellent communication skills, both written and verbal that present clear and concise information to a diverse audience.
Appreciation of timeliness with resolving issues and determining priorities.
Solid understanding of Epic and Epic business tools
Performance Expectations:
Successful achievement of the following:
Strong Analytical skills
Must be able to work independently and efficiently with little supervision.
Strong customer service and human relations abilities
Ability to effect collaborative alliances and promote teamwork.
Ability to manipulate large sets of data in multiple databases is required.
Ability to use various computer applications is preferred including Epic.
Ability to make good judgments in demanding situations.
Ability to react to frequent changes in duties and volume of work.
Ability to recognize, evaluate, solve problems, and correct errors.
Ability to identify and implement process improvements to optimize revenue cycle performance.
Preferred Requirements
Preferred Education:
Additional Epic certification in Cadence and Prelude
Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare and North Carolina Medicaid reimbursement methodologies.
Knowledge of third-party payer reimbursement methodologies and contracts
General Statement
It is the goal of ECU Health and its entities to employ the most qualified individual who best matches the requirements for the vacant position.
Offers of employment are subject to successful completion of all pre-employment screenings, which may include an occupational health screening, criminal record check, education, reference, and licensure verification.
We value diversity and are proud to be an equal opportunity employer. Decisions of employment are made based on business needs, job requirements and applicant's qualifications without regard to race, color, religion, gender, national origin, disability status, protected veteran status, genetic information and testing, family and medical leave, sexual orientation, gender identity or expression or any other status protected by law. We prohibit retaliation against individuals who bring forth any complaint, orally or in writing, to the employer, or against any individuals who assist or participate in the investigation of any complaint.
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