Senior Revenue Cycle Analyst

3 weeks ago

SetauketEast Setauket, New York, United States Stony Brook Medicine Full time
Job Summary

The Senior Revenue Cycle Analyst will provide analytical and systems support within the hospital's Business Office. This role will act as a lead in developing and generating all data analytics pertaining to revenue cycle activities and key performance indicators (KPIs).

Key Responsibilities
  • Develop and generate data analytics for revenue cycle activities and KPIs
  • Provide analytical and systems support within the Business Office
  • Work closely with subject matter experts to support day-to-day business functions, performance improvement initiatives, reconciliation, benchmarking, and reporting
  • Extract, collate, and refine 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, prepare and standardize monthly reports, and develop new report templates for detailed ad-hoc inquiries
  • Analyze data trends to determine the root cause and conduct deep dive sampling, perform denials analysis to identify solutions and reduce controllable rejections
  • Provide a detailed assessment of revenue cycle processes with a focus on process improvement and best practices
  • Prepare dashboards to identify trends and gaps and ensure a holistic view of the revenue cycle, perform extensive evaluation using multiple methodologies
  • Monitor and track ongoing performance through key performance indicators (KPI) in comparison to industry benchmarks
  • Present data analysis for departmental leadership in organized format to clearly convey trends and identify key areas for revenue optimization
  • Highlight corrective solutions to minimize delays and denials to advance performance and achieve targets
  • Support data collection for audit and discovery, cultivate effective collaborative relationships with departmental teams to seek resolution of issues identified through monthly monitoring of KOIs/KPIs
  • Work closely with Department management to facilitate root issue remediation, collaborate closely with peers to develop, validate, and maintain meaningful report sets
  • Recommend and implement best practices within the departments, stay abreast of group payer contracts, payer policies, payer plans, and member benefits
  • Carry out duties in compliance with all federal and managed care and clinical research billing guidelines, keep apprised of rules and regulations affecting reimbursement
  • Prioritize requests and implement timely escalation to the appropriate teams for resolution and corrective actions
  • Perform other special projects and duties as needed or assigned
Qualifications
  • Bachelor's of Science in Accounting or Finance, Health Information Management, Health Administration, Computer Science, or related field and 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
  • Experience in an Acute Care Hospital/Health System Revenue Cycle, Accounting, Finance, Information Technology, or Decision Support role, 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.)
  • Excellent written and verbal communication skills
Preferred Qualifications
  • 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

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