Revenue Cycle Analyst

Job Description:

Revenue Cycle Analyst

This job description outlines a role responsible for overseeing a customer’s RCMS contract, ensuring the smooth functioning of the revenue cycle across multiple business accounts, and ensuring key performance indicators (KPIs) are met.

About the Role:
The ideal candidate should have advanced RCM knowledge, problem-solving abilities, and experience in resolving complex customer issues. They will collaborate with teams, lead billing operations, and report monthly performance.

Responsibilities:

• Oversee a customer’s RCMS contract

• Ensure the smooth functioning of the revenue cycle across multiple business accounts

• Ensure key performance indicators (KPIs) are met

• Collaborate with teams

• Lead billing operations

• Report monthly performance

• Responsible for providing oversight of a customer’s RCMS contract

• Ability to address multiple markets of business accounts

• Ensure the revenue cycle is processing appropriately and KPIs are within expected parameters

Knowledge & Application

• Exhibits advanced RCM knowledge

• Possess wide-ranging experience using in-depth professional knowledge, acumen, concepts, and company objectives to develop and resolve complex customer business requirements

• Provides solutions to issues in creative and effective ways, understanding the interrelationships of different EHR functionality and impacts

• Complexity & Problem Solving: Advises on or serves as advisor on complex customer issue analysis that requires evaluation of identifiable factors

• Devises solutions based on limited information and precedent and adapts existing approaches to resolve issues

• Uses advanced knowledge, evaluation, judgment, and interpretation to select the right course of action

• Assesses agency billing requirements, EDI files, and other RCM processes, seeks collaborative solutions, and prepares and presents recommendations

• Resolves concerns with team members with minimal support from leadership to ensure a productive revenue cycle

• Leads an identified effort of complex RCM billing and reporting requirements, seeks collaborative solutions, and prepares and presents recommendations

• Excellent written and oral communication skills

• Ability to think quickly and logically to ensure solutions are identified

• Strong attention to detail and follow-through skills

Duties and Responsibilities

• Maintain & coordinate billing operations and support actions with other team members

• Lead efforts in payer and industry research impacting customers’ businesses

• Coordinate with team members to ensure metrics are met for contracts assigned

• Maintain skills of Senior Billing Specialist; step in and help team members to maintain contractual KPIs

• Monitor accounts for KPI performance and escalations

• Creation of month-end reporting and submission to provider practices

• Assist in process development

• Substantial understanding of medical billing, revenue cycle, and application of knowledge and skills to oversee customer contract(s)

• Identify trends, root causes, and design solutions with minimal leadership support

Qualifications

• Bachelor’s degree and 6–8 years of medical billing experience

• Excellent Excel skills

• Ability to identify trends and design solutions independently

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.