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Revenue Cycle Data Analyst

1 month ago

Edinburg, United States DHR Health Full time

DHR Health - US:TX:Edinburg - Days

Summary:

POSITION SUMMARY:

The successful candidate will assist the Chief Revenue Cycle Officer and the Contract Manager of the Revenue Cycle with in the operations of the Revenue Cycle Departments of the Doctors Hospital of Renaissance and the Renaissance Medical Foundation. This position will require preparing forecasts, performing cost and variance analysis of patient accounts data, assuring the accuracy of Aged Trial balance, and providing assistance in long range planning and profitability assessments. Also includes budgets and cost report preparation, statistical analysis by departments and service lines. Understanding of the different reporting systems, Paragon, PIC, Medisoft, Premier, and all Revenue Cycle systems.

POSITION EDUCATION/ QUALIFICATIONS:

  • College degree in Business or Computer related field preferred
  • Must be able to be sensitive to cultural and bilingual issues.
  • Good written and verbal communication skills required.
  • Ability to read, write and speak English
  • Ability to communicate clearly and concisely with all levels of nursing, administration, and physicians
  • Prefer hospital experience
JOB KNOWLEDGE/EXPERIENCE:
  • Two (2) years' experience, prefer healthcare experience, but not required.
  • Must able to work under pressure and to meet deadlines.
  • Requires reasoning ability, good independent judgment, and the ability to work with frequent interruptions.
  • Must project a professional image.
  • Working knowledge of personal computer and Microsoft Office is required.
  • A good understanding of excel functions, formulas, formatting and Pivot tables is required.
  • A good understanding of database modeling is also likely to be required.
  • Being able to communicate this information on paper and in conversation to audiences with varying levels of understanding is also critical.
Responsibilities:

POSITION RESPONSIBILITES:
  • Promotes the facility mission, vision and values by effectively communicating them to others. Considers mission, vision and values in developing services, standards and practice
  • Ability to run Crystal reports, Paragon reports and Medisoft reports, Premier reports, PIC reports
  • Responsible for the coordination of Insurance plans Additions/ Revisions/ Deletions in PIC.
  • Responsible for WEBTPA out of network reimbursement calculation on Facility and Professional services.
  • Weekly will run and format Denial reports to be handed off to Special projects coordinator for the RMF.
  • Monthly will run the PS&R report for shadow billing and provide to Chief Revenue Cycle Officer.
  • Monthly will run and compile Denials report for Chief Revenue Cycle Officer for the RMF.
  • Monthly will review Medicare factors, Wage Index to determine the correct SDA amounts and coordinate with PIC for updated reimbursement.
  • Monthly will validate the DRG table and coordinate with PIC for updated reimbursement.
  • Monthly will provide RMF Appeal Log to Chief Revenue Cycle Officer.
  • Monthly will update PIC
  • Quarterly will pull Addendum B and apply to PIC
  • Liaison between Business office and Contract Manager
  • Liaison for Contract Provider Reps
  • Assist in Contract Negotiation and modeling.
  • Develops reports to determine/assist with various projects and performs statistical analysis based on this data for both DHR and RMF.
  • Examines historical and current financial data to provide to both DHR/RMF Revenue Cycle management with valuable data upon which to make relevant financial decisions.
  • Responsible for the coordination, preparation and analytical review of both the DHR/RMF Revenue Cycle, financial reports.
  • Analyzes and prepares various reports for both internal use and as required for external agencies for both the DHR/RMF Revenue Cycle departments.
  • Assist with the collection of data for the State and Federal reports.
  • Assist in preparation of month end reports for both DHR and RMF Revenue Cycle.
  • Performs related duties as required for both DHR/RMF Revenue Cycle.
  • Other duties as assigned for DHR/RMF Revenue Cycle.


Other information:

LINES OF REPSONSIBILITES:

(Chain-of-command)

1. Contract Manager → 2. Chief Revenue Cycle Officer

CUSTOMER SERVICE:

Provide excellent customer service to all DHR customers. All employees are required to attend the DHR C.A.R.E.S program which outlines the Customer Service Principals including: Commitment, Accountability, Respect, Excellence and Service.

AGE SPECIFIC:

Employees must be able to demonstrate the knowledge and skills necessary to provide care appropriate to the age of the patients served in his/her assigned unit. The individual must demonstrate knowledge of principles of growth and development over the life span and possess the ability to assess data reflective of the patient's status and interpret the appropriate information needed to identify each patient's requirement relative to his or her age.

AMERICANS WITH DISABILITIES ACT: (ADA):

A. Essential Duties: Indicated by bold print within performance standards, preceding individual numbered criteria.

The following table provides physical requirements that will be associated with, but not limited to, this position:
• Light/moderate lifting up to 20 lbs, from the floor to shoulder height.
• Yes
• Kneeling
• Yes
• Must be able to assist other employees with lifting more than 20 lbs.
• Yes
• Walking
• Yes
• Light/moderate carrying up to 20 lbs.
• Yes
• Standing/Squatting
• Yes
• Straight pulling
• Yes
• Sitting
• Yes
• Pulling hand over hand
• Yes
• Pushing
• Yes
• Repeated bending
• Yes
• Stooping/Bending
• Yes
• Reaching above shoulder
• Yes
• Climbing Stairs
• Yes
• Simple grasping
• Yes
• Climbing Ladders
• No
• Dual simultaneous grasping
• Yes
• Depth Perceptions needed
• Yes
• Ability to see
• Yes
• Identify Colors
• Yes
• Operating office equipment
• Yes
• Twisting
• Yes
• Operating mechanical equipment
• Yes
• Crawling
• No
• Ability to read and write
• Yes
• Ability to Count
• Yes
• Ability to hear verbal communication without aid
• Yes
• Operating Personal Vehicle
• Yes
• Ability to comprehend written/verbal communication
• Yes
• Other: Ability to deal with stress
• Yes
• OSHA Category
• III
•
•B. Working Conditions: The individual spends over 95% of his/her time in an air-conditioned environment with varying exposures to noise. There is protection from weather conditions but not necessarily from temperature changes. The position does have low exposure to malodorous, infectious body fluids from patients and some minimal exposure to noxious smells from cleansing agents.

C. Occupational Exposure: This position has minimal to no exposure to blood, body fluids, or tissues and is an OSHA Category III (although situations can be imagined or hypothesized under which anyone, anywhere, might encounter potential exposure to body fluids). Person who performs these duties are not called upon as part of their employment to perform or assist in emergency medical care or first aid or to be potentially exposed in some other way.

D. Aptitudes: HIGH 1 2 3 4 5 6 LOW

Intelligence: General learning ability: The ability to "catch on" or understand instructions and underlying principles. Ability to reason and make judgments. 3

Verbal: Ability to understand meanings of words and ideas associated with them, and to use them effectively. To comprehend language, to understand relationships between words, and to understand meanings of whole sentences and paragraphs. To present information or ideas clearly. 3

Numerical: Ability to perform arithmetic operations quickly and accurately. 2

Spatial: Ability to comprehend forms in space and understands relationships of plane and solid objects. Frequently described as the ability to "visualize" objects or two or three dimensions, or to think visually of geometric forms. 2

Form Perception: Ability to perceive pertinent details and objects or in pictorial or graphic material to make visual comparisons and discriminations and see slight differences in shapes and shadings of figures and widths and lengths of lines. 3

Clerical Perception: Ability to receive pertinent details and verbal or tabular material. To observe differences in copy, to proofread words and numbers, and to avoid perceptual errors in arithmetic computation. 2

Motor Coordination: Ability to coordinate eyes and hands to fingers rapidly and accurately in making precise movements with speed. Ability to make a movement response accurately and quickly. 3

Finger Dexterity: Ability to move hands easily and skillfully. To work with fingers in placing and turning motions. 3

Manual Dexterity: Ability to move hands easily and skillfully. To work with hands in placing and turning motions. 3

Eye-Hand-Foot Coordination: Ability to move the hand and foot coordinately with each other in accordance with visual stimuli. 3

Color Discrimination: Ability to perceive and respond to similarities or differences in colors, shapes, or other values of the same or different color. To identify a particular color, or to recognize harmonious or contrasting color combinations, or to match color adequately. 3

I have read and reviewed my job description with my supervisor or designee and I understand the job I am expected to perform.

If applicable ____________ certification will be completed within _________ time frame of hire/transfer date.

Employee Signature: ________________________________ Date: ____________________

Transfer/Hire Date Effective: ________________________.