Revenue Cycle Analyst

JOB SUMMARY 

The position involves providing technical training and support to associates and facilities, focusing on comprehensive billing and financial processes. Key responsibilities include preparing analytical reports on key performance indicators (KPIs) such as transport volume, collections, aging balances, payment trends, and denials. The role requires conducting Quality Assurance (QA) audits to ensure compliance with regulations and funding program terms, collaborating with billing companies to resolve complex billing issues, and analyzing financial reports to address anomalies. The candidate will also support policy and procedure development in collaboration with the CFO, research and resolve unidentified funds and credit balances, and address delinquent accounts with payors. Additional tasks include reviewing denial patterns, assisting with prebilling reviews, establishing contracts with facilities and payors, and managing Medicare, Medicaid, and DSHS revalidation processes. This role will also work closely with the CFO on various projects as they arise. 

MAJOR JOB RESPONSIBILITIES 

• Train and provide technical support to associates, facilities, etc.; 

• Prepares analytical reports related to key KPIs which include transport volume, collections per transport, aging balances, payment trends, denials, etc.; 

• Provide technical support to CEMS associates; 

• Conduct Quality Assurance (QA) audit of CEMS Billing Company, compliance with related regulations, and terms?and condition of specified funding or programs; 

• Work with billing company to resolve complex billing errors, misapplied funds, and other business-related anomalies, inclusive of?conducting applicable research; 

• Answers questions that involve searching for, and abstracting and manipulating technical data from sources; 

• Applying organizations policies, procedures, and guidance along with Federal and State regulations in the commission of duties; 

• Collaborate with CFO to write fiscal/billing processes and procedures that align with Division workflows; 

• Analyze various reports toidentifyand address any noted anomalies; 

• Work with billing company to research unidentified funds and credit balances todetermineproper action (refund, posting error, contractual adjustment error, which accounts they should be attributed to, etc.); 

• Serves as back-up to co-workers and may serve as back-up for higher-level employees; 

• Review denial reports todeterminepatterns and to address issues as they arise. 

• Prepare,auditand analyze computer-generated spreadsheets, billing company reports, etc. to help develop and implement process improvements. 

• Work withpayors, including facilities, to collect delinquent accounts. 

• Assistwith prebilling review as needed; 

• Assistwith the establishment of contracts with facilitiesand otherpayors. 

• Assistswith the process of Medicare, Medicaid & DSHS revalidation. 

• Assistwith the process of assessing and making recommendations about charge master rates. 

• Performs other related job duties as assigned. 

JOB STANDARD QUALIFICATIONS 

1. Education/Skills 

• Bachelor’s Degreeor equivalent years of experiencerequired. 

1. Experience 

• 5 – 7 years of experiencepreferred. 

1. Licenses, Registrations, orCertifications  

• Nonerequired.CAC and/or other billing certification preferred