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Senior Revenue Cycle Analyst

2 months ago

Boston, Massachusetts, United States East Boston Neighborhood Health Center Full time
Senior Revenue Cycle Analyst
Remote, Part-time

Are you a seasoned Revenue Cycle Analyst looking for a part-time remote opportunity? Reporting directly to the department manager and under the guidance of the Lead Biller, the East Boston Neighborhood Health Center Revenue Cycle Analyst is responsible for a comprehensive range of billing tasks aimed at reducing accounts receivable and improving collection efficiency. This role requires the ability to utilize payer and industry expertise, collaborate effectively within the Patient Accounts team, and engage in various revenue cycle activities with minimal oversight. Proficiency in electronic medical billing systems and a thorough understanding of medical billing and insurance regulations are essential for resolving accounts receivable challenges. This position acts as the primary resource for complex issues and specific responsibilities.

Key Responsibilities:
  • Achieve deadlines and productivity benchmarks for Epic work queues, including but not limited to insurance verification (Epic RTE), denial management (analyzing root causes, identifying trends, correcting, and appealing), claim edits (ensuring clean claim submissions), and transaction history (tracking claim submissions and payer responses).
  • Prioritize Epic work queues, projects, and accounts, providing timely feedback to management.
  • Leverage payer websites to investigate policies and coverage eligibility for claim adjudication, trend analysis, and process enhancement.
  • Utilize MS Office, particularly Excel, to document, analyze, and communicate workflow assignments, trends, and essential performance information.
  • Implement transfers and/or adjustments to invoices as needed to resolve each billing issue.
  • Possess knowledge of ICD-10, modifiers, revenue codes, HCPCS, and CPT codes.
  • Coordinate data for special billing projects in accordance with contractual obligations and regulatory requirements.
  • Apply expertise in insurance rules and regulations to interpret new insurance/HCFA/UB/HIPAA information and assess potential impacts.
  • Collaborate with EBNHC Patient Accounts Leadership and various payers as part of the contact group responsible for updates and information to assist others in the organization.
  • Engage in various projects and testing of updates for evaluation and implementation.
  • Maintain positive interpersonal relationships with stakeholders both internal and external to the department.
  • Provide insights to assist EBNHC management in formulating strategies to enhance financial service operations.

Qualifications:
  • Minimum of 3 years of Epic PB Resolute experience required.
  • Demonstrated proficiency with various automation tools, including but not limited to Epic, Microsoft Word, Excel, Email, and electronic data processing skills.
  • High School Diploma or equivalent; Bachelor's degree preferred.

East Boston Neighborhood Health Center embraces diversity and is committed to creating an inclusive environment for all employees. Our workforce reflects the rich diversity of the community we serve.