Healthcare Revenue Cycle Specialist

2 weeks ago

Strongsville, Ohio, United States Addus HomeCare Full time
Position Overview:

The Healthcare Revenue Cycle Specialist is tasked with the critical role of evaluating and reporting on essential business metrics within the Reimbursement division.

This role is pivotal in monitoring and documenting data that informs business strategies, management decisions, and productivity across various metrics, including Expiring Authorizations, Days Sales Outstanding (DSO), aged Accounts Receivable (AR), timely submissions, cash inflows, and write-offs. All reporting must align with company policies and adhere to regulatory and payer compliance standards.


Key Responsibilities:


1. Analyze and deliver timely reports on vital Revenue Cycle metrics, ensuring meticulous preparation and maintenance of internal reports for management review, which includes DSO, aged AR, write-offs, and productivity indicators.

2. Develop and sustain financial and operational reports on a daily, weekly, monthly, quarterly, and annual basis, highlighting trends in key metrics to facilitate informed decision-making and enhance productivity.

3. Manage the dissemination of Expiring Authorization and Certification reports, collaborating with various branches and management to achieve benchmarks regarding their status and timeliness.

4. Generate reports for and engage with senior management and internal/external auditors, while monitoring data trends to proactively identify reimbursement challenges.

5. Assist in preparing and presenting reports for regular meetings focused on Accounts Receivable management and Financial Reviews.

6. Conduct specific reviews of billing, collection, or cash application data and processes, including payer monitoring and aged accounts receivable analysis.

7. Support internal audits as needed, including testing of internal controls.

8. Participate in special projects, which may involve payer research or requirements for integrating acquired entities into existing processes and systems.

9. Contribute to all performance improvement initiatives.

10. Uphold the highest level of confidentiality and comply with all relevant regulations, including SOX and HIPAA.


Qualifications:
• A Bachelor's degree in Accounting, Finance, or a related field, or an equivalent combination of education and experience.
• A minimum of 2 years of experience in statistical or data analysis.
• Proficient in Microsoft Office Suite, particularly Excel and Access, with a strong ability to analyze large datasets and create comprehensive reports.
• Familiarity with healthcare data, payer systems, and billing/collections processes is preferred.
• Excellent communication skills, capable of documenting and conveying data insights and any operational or financial issues identified through analysis.

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