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Revenue Cycle Operations Analyst

2 months ago

Irvine California, United States Discovery Behavioral Health DBH Full time

Position Overview:
The Revenue Cycle Operations Analyst will collaborate across various Revenue Cycle divisions to evaluate and enhance workflows and procedures, ensuring adherence to established best practices.


Key Responsibilities:
  • Conduct internal assessments of Revenue Cycle operations and personnel, providing constructive feedback to relevant leadership.
  • Support external payer evaluations, tracking performance, and liaising with payer representatives and internal teams for swift resolution of issues.
  • Address denials through escalation processes and appeals.
  • Investigate contract discrepancies related to underpayments.
  • Evaluate accounts for potential placement with state insurance boards as necessary.
  • Analyze out-of-network reimbursements for post-discharge settlements and underpayment disputes.
  • Manage escalated accounts from the Business Office.
  • Collaborate with the contracting team to identify and rectify systemic payer challenges.
  • Review Revenue Cycle performance metrics, implementing and overseeing improvement strategies with relevant departments.
  • Analyze all accounts receivable to uncover payer trends and patterns.
  • Assist in pinpointing opportunities for improvement to meet established financial and operational goals, communicating urgent findings to the Director.
  • Support the evaluation, selection, and implementation of EHR/Revenue Cycle management software.

Essential Skills:
  • Exceptional communication skills, with the ability to articulate ideas clearly and professionally.
  • Strong organizational skills, with the capacity to prioritize tasks and manage time effectively.
  • Proficient research and auditing capabilities.
  • Ability to analyze financial data and assess its impact on the organization.
  • Proactive problem-solving skills, with a focus on timely issue resolution.
  • Familiarity with federal and state regulations.
  • Knowledge of major commercial payers.
  • Experience in reviewing, interpreting, and implementing managed care agreements with third-party payers.
  • Expertise in Denials Management, including reporting and resolution.
  • Proven ability to identify process improvement opportunities and critically evaluate workflows.
  • Demonstrated proficiency in Microsoft Office Suite, including spreadsheets, databases, and project management tools.