Associate Revenue Cycle Analyst - Prior Authorizations

Job Summary:

The Associate Revenue Cycle Analyst will be responsible for building and maintaining collaborative and productive relationships within the organization relating to Revenue Cycle Management, managing revenue cycle projects, driving performance in operations related to reimbursement and providing analysis and oversight of processes impacting cash collections.

Job Responsibilities:

• Serves as a source of knowledge for the Prior Authorization function within revenue cycle.

• Performs analysis, identifies trends, presents opportunity areas, and prioritizes initiatives for performance improvement for the designated revenue cycle function.

• Assist with developing appropriate workflows and tracking for the designated revenue cycle function.

• Establishes an ongoing working relationship with other departments impacting revenue cycle performance.

• Works closely with the vendor operations teams to oversee operations activities that directly impact the revenue cycle to accurately process actions in a timely manner for optimal reimbursement.

• Tracks on-going performance of revenue cycle metrics and activities to ensure goals are met.

• Assists with weekly meetings to review key metrics, workflows, trends, and performance improvement opportunities.

• By continually reviewing and monitoring billing and coding changes, researches, evaluates, and interprets guidance from a variety of sources to determine departmental actions.

• Coordinates with Management to ensure thorough understanding of trends/issues affecting revenue cycle performance.

• Supports goals and metrics to link department and revenue cycle initiatives with the organization's strategy.

• Develops, manages and monitors successful completion of implementation and project plans.

• Acts as an educator on performance improvement requirements in operations and methodologies to related teams and departments.

• Continuously seek new and creative technologies that help identify and guide improvement opportunities that align with overall company success.

Qualifications: 

• Bachelor’s Degree in business or healthcare related field of study, or equivalent years of experience.

• At least 2-4 years of experience in medical billing and Insurance collections.

• Knowledge of CPT/HCPCS. ICD-10, modifier selection, and UB revenue codes.

• Intermediate proficiency in Excel (pivot tables, LOOKUPS, etc.)

Required Knowledge, Skills and Abilities:

• Proficiency with medical billing systems, Microsoft Excel, medical terminology and basic procedure coding knowledge.

• Knowledge of medical terminology and abbreviations, and health care nomenclature and systems.

• Strong communication (verbal and written), organizational, problem solving and team player skills.

• Ability to navigate across multiple customer demands and balance competing priorities successfully.

• Ability to analyze, identify and articulate identified trends and report trends succinctly in a clear and concise manner.

• Ability to solve problems using critical thinking skills.

• Maintains confidentiality of sensitive information.

• Analytical skills required.

• Ability to think critically and identify the impact across the revenue cycle with a solution oriented approach.

• Ability to develop, implement and produce analysis and reports.

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