Lead Revenue Cycle Analyst

2 weeks ago

Coppell, Texas, United States Fulgent Genetics Full time
Position Overview

Lead Revenue Cycle Analysts play a crucial role in the resolution of intricate billing challenges and the collection of payments related to complex transactions. This position demands exceptional problem-solving abilities to address complicated billing discrepancies, outstanding claims, and customer inquiries, ensuring that all necessary steps are taken to coordinate corrective actions across multiple functions for the prompt resolution of payments.

Key Responsibilities
  • Manage communications regarding insurance or patient accounts, proactively engaging with insurance providers to maximize payment on accounts while identifying issues and necessary corrective measures.
  • Analyze trends to mitigate reimbursement challenges and prevent delinquent accounts. Utilize trend analysis and pattern recognition to pinpoint defects and eliminate them at their source.
  • Collaborate with leadership and essential stakeholders to propose effective solutions.
  • Thoroughly review all documentation to guarantee compliance with billing standards.
  • Communicate vital information to insurance companies, patients, and management, both verbally and in writing, to ensure timely resolution of concerns and full settlement of accounts.
  • Engage with carriers, patients, and management at all levels to achieve optimal payment resolutions and identify issues or changes necessary for profitability.
  • Develop expertise in payor fee schedules and denial management.
  • Exhibit a comprehensive understanding of Medicare, Medicaid, and private payor policies and guidelines.
  • Investigate and resolve claim denials, making informed decisions to enhance reimbursement outcomes.
  • Utilize aging reports to address unpaid claims effectively.
  • Handle complex projects and assignments that require advanced knowledge and experience in insurance accounts receivable.
  • Assist with additional related duties and special projects as required.
Qualifications
  • High School Diploma or GED.
  • A minimum of 4 years of experience in a complex healthcare billing reimbursement environment.
  • Advanced knowledge of government and private payor reimbursement is essential.
  • Experience in anatomic pathology or diagnostic laboratory settings is advantageous.
  • Strong interpersonal skills are necessary, as this role involves interaction with a diverse range of colleagues, clients, and stakeholders.
  • Maintain a high standard of professionalism and discipline.
  • Ability to think innovatively and propose new ideas or solutions to business challenges.
  • Demonstrated commitment, self-motivation, and drive are essential.
  • Capability to thrive in a fast-paced, deadline-driven environment.

This job description reflects management's assignment of essential functions. Management reserves the right to assign or reassign duties and responsibilities to this position at any time.

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