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Revenue Cycle Analyst
2 months ago
We are seeking a highly skilled Revenue Cycle Analyst to join our team at Trinity Health. As a key member of our revenue cycle team, you will play a critical role in ensuring the efficient and effective operation of our medical practice.
Key Responsibilities- Monitor and resolve claims work queues, including front-end, referrals, and authorizations, and clinical workflow.
- Monitor Trinity Health front-end metrics and work with practice management to identify educational opportunities as necessary.
- Review denial/rejection and write-off dashboards for trends and provide necessary education to providers and front-end users.
- Ensure all necessary referral documentation is obtained and documented to secure appropriate revenue.
- Run monthly reports to identify any outbound referrals and communicate back to manager for any improvement opportunities.
- Ensure all billable services are processed within the EMR in a timely manner.
- Ensure all billed services are submitted to insurances as "clean claims".
- Work within the working queue to review all charges and submit to claims scrubber.
- Work all claims scrubber edits in a timely basis.
- Identify any problematic charges for further review to correct coding/billing issues.
- Adhere to productivity/quality guidelines.
- Communicate effectively and professionally with other departments within the organization.
- Work with revenue cycle manager to identify needed feedback to practice locations.
- Process inpatient charges submitted by providers via interface tool or manual sheets.
- Manually enter charges as assigned and complete charge reconciliation daily.
- Report any outstanding claims to contact to ensure all claims are billed timely.
- Review each claim for appropriate information.
- Identify and review high-dollar outstanding balances and ensure financial assistance options are offered to patients and/or secured by front-end users.
- Provide necessary feedback from operational departments to revenue integrity team as appropriate.
- Act as a superuser for the site and act as a resource to ensure patient questions are answered.
- Maintain patient confidentiality and adhere to HIPAA regulations as appropriate.
- Daily TOS reconciliation with front-end.
- Work cooperatively with all team members to ensure quality service at all times.
- Perform mandatory in-service training.
- Maintain a clean and safe work environment.
- Adhere to the Trinity Health Medical Associates Code of Conduct in performance of all job duties.
- May be responsible for multiple providers or departments.
- Travel will be required as assigned by operational leader.
- High school diploma or equivalency required; associate's degree preferred.
- Effective written and verbal communication skills.
- 3+ years' experience in a physician practice or billing office.
- Demonstrated attention to detail, organization, and effective time management.
- Ability to work independently with little supervision.
- Knowledge of CPC.
- Knowledge of CPT, CPTII, and ICD10.
- Knowledge of insurance carriers.
- Solid judgment to escalate issues appropriately.
- Advanced knowledge of Microsoft Office, related computer programs, and general office machines.
- Ability to lift 20 lbs.
Pay is based on experience, skills, and education. Exempt positions under the Fair Labor Standards Act (FLSA) will be paid within the base salary equivalent of the stated hourly rates. The pay range may also vary within the stated range based on location.
Our Commitment to Diversity and InclusionTrinity Health is one of the largest not-for-profit, Catholic healthcare systems in the nation. Built on the foundation of our Mission and Core Values, we integrate diversity, equity, and inclusion in all that we do. Our colleagues have different lived experiences, customs, abilities, and talents. Together, we become our best selves. A diverse and inclusive workforce provides the most accessible and equitable care for those we serve. Trinity Health is an Equal Opportunity Employer. All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other status protected by law.
