REVENUE CYCLE ANALYST

Job Summary


About Us:

At Sinai Health System, Sinai Chicago, we take health care personally. Excellence in healthcare is about more than just medicine, technology, tests, and treatments; it is about really caring for people with dignity and respect. That is what we do. We are dedicated to providing the best care to meet the needs of people, for our community, for our patients and for you.

Position Purpose:

Provides support for the revenue cycle initiatives and conducts revenue cycle audits and reviews. Responsible for supporting and monitoring the performance of revenue cycle management standards, including CDM reviews and missing charge recovery. This position reports to the Manager of Revenue Integrity & Analysis.

Key Job Activities:

• Provides accurate data analysis and reporting relating to revenue cycle billing and coding.
• Periodically audits various elements of the revenue cycle, including patient accounts, and the charge description master (CDM), to monitor compliance and validate payment for services rendered. Assist with resolving revenue cycle compliance issues.
• Research revenue cycle issues at a detailed level to identify the root cause of recurring issues such as late charges and claim rejections.
• Collaborates with managers and staff to identify process flow and areas of improvement in order to maintain control over the revenue cycle process, so that departmental and organizational goals and objectives, such as accurate, timely and complete charge capture, can be achieved.
• Works with departments to establish elements of the revenue cycle for new services as need arises (charge description, master set up and reports etc.).
• Effectively communicate with Clinical departments, Patient Accounts, Information Systems, HIM and Managed Care departments.
• Evaluates the impact of current reimbursement/payment rules on various service lines, to ensure that legislative and regulatory changes impacting billing are quantified and communicated to all appropriate personnel.
• Performs other duties as assigned.

Education and Work Experience:

• Requires a Bachelor's degree in Applied Science, Business, Finance, or related field.
• Additional training in revenue cycle processes and healthcare payment methodologies is desired.
• Any equivalent combination of education and experience that provides the employee with the knowledge, skills, and ability to perform the work will be considered.
• Requires 1 - 2 years' experience in patient accounting, billing, or clinical work involving Medical Terminology, CPT/ICD-9 coding, DRG/APC payment classifications, and UB/HCFA regulatory requirements.
• Previous audit experience preferred.
• Basic knowledge of the field of hospital billing, finance, revenue cycle, and managed care.
• Specific knowledge of Medicare and Medicaid billing and coding regulations.
• Strong analytical skills.
• Excellent verbal and written communication skills.
• Experience with Microsoft Word, Excel, and Access.
• Basic knowledge of ICD-9CM and CPT coding

Knowledge and Skills:

• Experience in EPIC and MEDITECH software systems preferred.

Certifications/Licenses:

• None

Workplace Conditions:

PHYSICAL DEMANDS:

• While performing the duties of this job, the employee is regularly required to sit; use hands to finger, handle or feel; and talk or hear
• The employee is frequently required to walk and stoop, kneel, crouch.
• The employee is occasionally required to stand
• The employee must occasionally lift and/or move up to 25 pounds.
• Specific vision abilities required by this job include close vision, distance vision, and the ability to adjust focus.