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Healthcare Revenue Management Analyst
2 months ago
Atrius Health, a leader in innovative healthcare solutions, is dedicated to providing a seamless system of connected care for over 690,000 patients, both adult and pediatric, across various practice locations.
With a team of 645 physicians and primary care providers, alongside 420 additional clinicians, Atrius Health collaborates closely with hospital partners, community specialists, and skilled nursing facilities to enhance patient care.
Our mission is to revolutionize healthcare delivery to enrich lives. We are committed to offering high-quality, patient-centered, coordinated, and cost-effective care to all individuals we serve.
By fostering a strong foundation of shared decision-making, understanding, and trust, Atrius Health aims to improve the health and well-being of its patients.
Position Overview: Under general supervision, the Medical Revenue Analyst will provide analytical support, denial management, and accounts receivable oversight. This role involves gathering, compiling, and organizing claims and denial data.
The analyst will research clinical and payer information relevant to clinical and business initiatives, as well as ongoing clinical and billing processes. They will also address complex medical necessity and billing policy issues related to denied claims across all payers.
In accordance with departmental policies, the analyst will respond to payer claim audits, including Medicare, and will be responsible for writing complex clinical medical necessity appeals. Additionally, they will analyze claims data and billing issues to minimize errors and enhance revenue.
The role includes generating and compiling denied claim analyses, providing proactive denial interventions, reviewing claims for coding corrections, and applying charge corrections for special projects.
Qualifications:
- Bachelor's degree (or equivalent education, training, or experience) is required.
- Certification in medical coding is preferred, including CCS, CCS-P, CPC, or other relevant certifications through AHIMA or AAPC.
- A minimum of 3-5 years of experience in medical billing, denial management, or claims data analysis is required.
- Experience in medical policy/chart reviews for claim coding corrections and writing medical necessity appeals is a plus.
- Prior experience in generating and interpreting data and reporting analysis is essential.
Skills:
- Comprehensive understanding of medical terminology and clinical concepts, including diseases, therapies, drug treatments, and interpretation of lab and imaging tests.
- Knowledge of CPT and ICD10 codes is required.
- Detail-oriented with strong analytical, communication, and writing skills.
- Excellent organizational skills and the ability to manage multiple tasks accurately and simultaneously.
- Proficient in Microsoft Excel and other computer skills.
Atrius Health is committed to a policy of non-discrimination and equal employment opportunity, ensuring that all patients, employees, applicants, and other constituents are treated with respect and dignity, regardless of various dimensions of diversity.
Benefits Include:
- Up to 8% company retirement contribution
- Generous Paid Time Off
- 10 paid holidays
- Paid professional development
- Comprehensive health and welfare benefit package
