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Healthcare Revenue Management Analyst
2 months ago
Company Overview:
Atrius Health is a pioneering healthcare organization that provides a comprehensive system of connected care for over 690,000 patients, both adults and children, across 30 practice locations in eastern Massachusetts.
Our Mission:
We aim to transform healthcare delivery to enhance patient lives. Our dedicated team of 645 physicians and primary care providers, alongside 420 additional clinicians, collaborates closely with hospital partners, community specialists, and skilled nursing facilities to ensure high-quality, patient-centered, and cost-effective care.
Position Summary:
Under general supervision, the Medical Revenue Analyst will offer analytical support in denial management and accounts receivable. This role involves gathering, compiling, and organizing data related to claims and denials.
The analyst will conduct research on clinical and payer information to support clinical and business initiatives, as well as ongoing clinical and billing processes. This includes resolving complex issues related to medical necessity and billing policies for denied claims across all payers.
Key Responsibilities:
- Respond to payer claim audits, including those from Medicare, and prepare complex clinical medical necessity appeals.
- Analyze claims data and billing issues to minimize errors and enhance revenue.
- Generate and compile reports on denied claims, providing proactive interventions and reviewing claims for coding corrections.
- Apply charge corrections for special projects as needed.
Qualifications:
- A Bachelor’s degree or equivalent education, training, or experience is required.
- Certification in medical coding (CCS, CCS-P, CPC, or similar) is preferred.
- A minimum of 3-5 years of experience in medical billing, denial management, or claims data analysis is essential.
Skills Required:
- Proficient understanding of medical terminology and clinical concepts, including diseases, therapies, drug treatments, and lab test interpretations.
- Knowledge of CPT and ICD10 coding is necessary.
- Strong analytical, communication, and writing skills are essential, along with excellent organizational abilities to manage multiple tasks accurately.
Technical Proficiency:
- Must possess strong computer skills, particularly in Microsoft Excel.
Commitment to Diversity:
Atrius Health is dedicated to a policy of non-discrimination and equal employment opportunity, ensuring that all individuals are treated with respect and dignity, regardless of their background.
Benefits:
- Up to 8% company retirement contribution
- Generous Paid Time Off
- 10 paid holidays
- Paid professional development
- Comprehensive health and welfare benefit package
