Senior Revenue Cycle Analyst
3 weeks ago
Job Summary:
The Senior Revenue Cycle Analyst will provide analytical and systems support within the hospital's Business Office. This position will act as a lead in developing and generating all data analytics pertaining to revenue cycle activities and key performance indicators (KPIs).
Key Responsibilities:
- Extracts, collates, and refines data from multiple sources to manipulate into reporting sets using Excel, SQL, BI tools, Tableau, and other reporting tools.
- Create various reports to evaluate accounts receivables.
- Analyze data trends to determine the root cause and conduct deep dive sampling.
- Perform denials analysis to identify solutions and reduce controllable rejections.
- Provides a detailed assessment of revenue cycle processes with a focus on process improvement and best practices.
- Monitor and track ongoing performance through key performance indicators (KPI) in comparison to industry benchmarks.
- Presents data analysis for departmental leadership in an organized format to clearly convey trends and identify key areas for revenue optimization.
- Supports data collection for audit and discovery.
- Cultivates effective collaborative relationships with departmental teams to seek resolution of issues identified through monthly monitoring of KOIs/KPIs.
- Stays abreast of group payer contracts, payer policies, payer plans, and member benefits.
- Carries out duties in compliance with all federal and managed care and clinical research billing guidelines.
- Keeps apprised of rules and regulations affecting reimbursement.
Requirements:
- Bachelor's of Science in Accounting or Finance, Health Information Management, Health Administration, Computer Science, or related field.
- 3+ years' experience in an analytics, decision support, or information technology role preferably in a Healthcare or Healthcare Revenue Cycle setting.
- Proficiency in MS Office Suite including: Excel, Word, Access, Visio, PowerPoint.
- Knowledge and proficiency of SQL or Database reporting queries.
- Knowledge of Invision Patient Accounting, RPM, Contract Management, and/or Claims Scrubber Software.
- Experience reporting from healthcare decision support, patient accounting, contract management, and/or claims scrubber systems.
- Proficiency with visualization software (Tableau, MS Power BI, etc.).
- Master's degree in Accounting or Finance, Health Information Management, Health Administration, Computer Science, or related field.
- Experience with inpatient and outpatient billing requirements (UB-04) and CMS Medicare and New York Medicaid reimbursement methodologies.
- Knowledge of third-party payer reimbursement methodologies and contracts.
- Knowledge of CPT, HCPCs, and ICD-10 coding principles.
- Proficiency with SAP Business Objects/Crystal Reports.
About Stony Brook Medicine:
Stony Brook Medicine is committed to excellence in diversity and the creation of an inclusive learning and working environment. All qualified applicants will receive consideration for employment without regard to race, color, national origin, religion, sex, pregnancy, familial status, sexual orientation, gender identity or expression, age, disability, genetic information, veteran status, and all other protected classes under federal or state laws.
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