General Summary: The Revenue Cycle Analyst provides core business intelligence that enables the Revenue Cycle Management Team to report on performance, expenses, and effectiveness of clinical revenue billing and collections of the KMSF Professional Billing Office. Responsibilities include analyzing data in coordination with clinical and financial management goals, benchmarks and objectives in assigned area(s), and preparing reports and presentations that communicate complex analysis and findings in a concise and interpretable manner to support strategic initiatives. The Revenue Cycle Analyst analyzes established performance metrics, billing practices, and accounts receivables to assist the KMSF Professional Billing Office with meeting or exceeding its goals on all aspects relating to the billing and collection of professional services.
This position works to appropriately integrate operations, facilitate best practices, achieve efficiencies, and align with KMSF’s and UKHC’s strategic plan while maintaining quality standards and ensuring the department is operating within rules and regulations of KMSF, State and Federal laws and regulations.
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities and activities may change at any time with or without notice.
Job Duties and Essential Functions:
1. Runs, reviews, interprets, analyzes and validates Revenue Cycle reports. Ensures the integrity of data provided to all areas of the revenue cycle and other areas of the organization is necessary for good decision making. Works closely with stakeholders from different functional units on topics, including billing, charge capture, coding, edit/denial management, and/or self-pay management.
2. Financial Analysis
a. Analyzes and reports internally on service delivery and performance metrics in a proactive and timely manner.
b. Assists with identification of trends and other results of analysis with appropriate internal staff.
3. Reimbursement Analysis
a. Analyzes accounts receivables including trends, cash results, aging, bad debt and payment success.
b. Assists with analyses of impact of new regulations or codes from a coding, compliance and reimbursement perspective.
c. Monitors denials, reductions, rejections and overpayments and works with Revenue Management Team to develop solutions.
4. Assists with initial analyses and report preparation for month-end close meetings.
5. Produces scheduled and ad hoc reports for Revenue Cycle Team.
6. Maintains confidentiality of all patient demographic, medical, and financial information. Ensures proper handling and disposal of confidential documents and adherence to all HIPAA rules and regulations.
7. Maintain Master Files that support the Revenue Cycle processes and functions.
a. Perform on-going maintenance
b. Analyze and document gap performance issues
8. Attends internal Revenue Management meetings.
Education Requirement: Bachelor’s Degree in business, finance or health related field, or equivalent combination of education and experience in a health care field required.
Experience Requirement: Six months or more of experience in financial analysis/forecasting or healthcare revenue cycle; relevant internship(s) will be considered as part of experience.
Other Requirements: Valid Driver’s License and reliable transportation for local job-related travel
Equipment Operated: Standard office equipment including computers, copiers, printers, telephones, etc.
Work Environment: Work may be performed in a variety of temperature-controlled, well-lighted office and clinical environments and may require occasional evening and weekend work.
Mental/Physical Requirements: Involves sitting approximately 90 percent of the day, walking or standing the remainder.
Knowledge, Skills & Abilities:
1. Solid analytical, quantitative reasoning and problem-solving skills
2. Strong proficiency in Advanced Excel including Pivot, Lookups, Data Scrubbing, Data Consolidation, Reporting
3. Excellent interpersonal skills with solid written and oral communication and presentation skills
4. Proficiency in MS Office applications, including Word, PowerPoint, Excel, Access, and Outlook
5. Proficiency with Tableau Software, Microsoft SQL and/or VBA is preferred
6. Ability to succeed in a high-performance environment where client expectations are consistently met or exceeded
7. Must demonstrate the ability to –
a. Analyze and synthesize large amounts of data
b. Identify trends, interpret their meaning, and offer ideas and solutions
c. Understand the implications of each element in the revenue cycle and be proactive with reporting findings to Revenue Cycle Team.
d. Work both independently and in team environments / projects
e. Manage time effectively, multi-task and manage competing priorities
f. Meet deadlines
8. Will be expected to possess and/or acquire knowledge and understanding of the following:
a. Medical professional fee billing guidelines and compliance thereto
b. CPT, HCPCS, ICD-9, ICD-10
d. Teaching rules
e. Payor edits
g. Accounts Receivable
h. Co-pays, Co-Insurance and Deductibles