Revenue Cycle Analyst (Healthcare)

Location: Carroll, IA
The Reimbursement Analyst is responsible for helping manage the financial resources of the Hospital & Nursing Home by conducting a thorough analysis on reimbursement data to create reports identifying trends by payer and departments within the organization . The Reimbursement Analyst will regularly compile reports to provide leadership with an overview of the organization’s financial performance and will also create cost reports to meet reporting requirements of third-party payers. This position will look for opportunities to enhance reimbursement processes and will provide consultation on reimbursement practices to mitigate denials and revenue leakage.

Principal Duties and Responsibilities
  • Reviews reimbursements and variance reports to identify and trend payment discrepancies (e.g., denials, underpayments, etc.), reporting results to leadership on a regular basis
  • Conducts ongoing analysis of contract compliance and financial performance for third-party payers to provide leadership with support during payer contract negotiations
  • Interprets compiled dashboard data and develops regular reimbursement reports to explain trends and identify root causes of financial performance for the organization’s financial leaders
  • Analyzes dashboard data to identify potential gaps in the department’s reimbursement process flows
  • Helps design and implement improvements to established or proposed reimbursement process flows in an effort to maximize potential revenue
  • Stays apprised of current industry best practices and aligns departmental processes with applicable practices as needed
  • Identifies and works with IT to rectify any claims data transmission issues as they arise
  • Regularly evaluates departments’ performance both qualitatively and quantitatively as it relates to reimbursement
  • Acts as the designated liaison for payers, as well as for other internal departments and leadership, regarding payment accuracy
  • Identifies potential sources of revenue leakage and assists in developing data-driven initiatives to resolve any issues

Position Qualifications Education
  • Bachelor’s degree in business, accounting, healthcare administration, or finance required Experience
  • At least 2-3 years of experience in healthcare accounting or finance required

Knowledge, Skills, Abilities
  • Knowledge of third-party payer regulations, reimbursement, and payment policies
  • Understanding of billing practices and operational workflows
  • Understanding of medical terminology and medical record coding
  • Proven analytic and problem-solving skills
  • Strong interpersonal skills and the ability to work collaboratively
  • Proficiency in utilizing Microsoft Excel and other database management software
  • Ability to extract and analyze relevant data
  • Ability to self-manage and prioritize multiple tasks
April A. Estes
Senior Recruiter
720-439-2609 Direct
april@proenlist.com 
www.proenlist.com 
www.medenlist.com 

www.linkedin.com/in/aprilaestes
 
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