Revenue Cycle Analyst

Revenue Cycle Analyst

The Revenue Cycle Analyst provides statistical and financial data enabling management to accurately monitor accounts receivable activity on an ongoing basis. Identifies issues for management regarding significant changes in various accounts receivable categories reflected in the daily dashboards and denial reports. Supports the Revenue Cycle team by monitoring key metrics related to revenue and accelerated cash flow. This position performs high level analysis of accounts receivable and uses considerable judgement to determine solutions to complex problems. All tasks must be performed in a timely and accurate manner. Meets with appropriate Revenue Cycle leaders and makes recommendations to prevent future denials and payment variances. Disciplines include but are not limited to Patient Accounting, Case Management, Health Information, Clinical, Training, Managed Care and IT. Duties performed are at multiple sites within the Hackensack Meridian Health (HMH) Network. The hours for this position are 8 a.m.–4:30 p.m. & Fully Remote.

Responsibilities

A day in the life of a Revenue Cycle Analyst at Hackensack Meridian Health includes:

• Participates & Reports on Weekly Graph & Workflow meetings on Denials trending for the Network. Identifies and performs root cause analysis of high volume denials, and presents the findings to the Revenue Cycle team. Communicates improvement opportunities and corrective actions based on findings.
• Act as Team Leader to ensure all team members are trained & aligned with established Desktop & policies & procedures.
• Performs analytical review of denials to support Revenue Operations, Case Management, Access, and other departments as it relates to denials and payment variances. Determines the reasons for denials, meets with appropriate Revenue Cycle leaders, and makes recommendations to prevent future denials and payment variances.
• Identifies problems in process flow or changes in payer's billing rules and regulations and governmental guidelines that slows cash flow and workflow and disseminates information to management.
• Collaborates with the Training department on developing education materials based from the resolutions/outcomes of the improvement opportunities presented at inter disciplinary meetings.
• Collaborates with Reconciliation Manager in developing processes and workflows on trends identified on various areas of operation.
• Performs accounts receivable and financial review for the Revenue department. Communicates revenue impact to the department and helps identify and recommend improvement opportunities.
• Prepares trending reports of all high volume denials and payment variances. Meets biweekly and monthly with various departments to communicate findings and recommendations to improve revenue management.
• Works closely with front-end (Access) regarding up-front cash collection, registration, and eligibility denials. Schedules biweekly meetings to resolve issues that will slow cash collection.
• SME (Subject Matter Expert) for complex denials and payment variances including contracts, fee schedules, and edits. Educates and provides feedback to various areas on Revenue Cycle metrics and key performance indicators.
• Utilizes and develops new Epic and ad-hoc accounts receivable or denial reporting tools for management, using the current information system and/or other software programs to achieve desired reporting outcomes.
• Tracks and reports on causes of manual adjustments which will be the basis of escalation to Information Technology for contract management corrections.
• Performs staff audits based on manual adjustment reports. Reviews activities to improve the revenue cycle. Ensures that the team is following departmental procedures and are in compliance with governmental and commercial payer guidelines.
• Performs reimbursement management, analyzes payer reimbursement to ensure proper claim adjudication, and tracks and reports on high volume payment discrepancies which will be used as escalation to Managed Care, the payer, or IT. Monitors payments denials and initiates CPT or DRG analysis to determine reasons for denial.
• Monitors daily dashboard and reports and conducts analytical reviews to determine if changes or enhancements on current policies and procedures are required.
• Participates, schedules, and coordinates meetings with appropriate personnel to exchange ideas on working towards accounts receivable related changes or enhancement and works closely with the Reconciliation Manager to develop required reports for the meeting.
• Conducts accounts receivable audits as defined by SVP, Sr Revenue Officer and Revenue Operations Managers. Analyzes manual adjustment reports monthly to evaluate appropriateness, and report findings to the SVP, Sr Revenue Officer.
• Calculates target/actual cash collection on a timely basis for management review and analyzes wide variations in the expected outcome.
• Meets biweekly and monthly with various vendors and outside agencies to discuss bottlenecks in revenue flow and discusses solutions. Acts as a liaison between agencies and Reconciliation department to prevent AR aging and timely flow of communication.
• Monitors account work queues, analyzes trends, and follows up if metrics exceed or fall below baselines.
• Assists with ongoing management of Epic as it relates to Resolute Hospital Billing Nova Notes and other Epic enhancements.
• Able to perform all Adjustment Representative functions/tasks and other duties as assigned.
• Other duties and/or projects as assigned.
• Adheres to HMH Organizational competencies and standards of behavior.

Qualifications

Education, Knowledge, Skills and Abilities Required:

• Bachelor's degree or equivalent work experience.
• Minimum of 4 years of related work experience.
• Strong analytical, mathematical, and report writing skills.
• Knowledge of computers or hospital billing systems.
• Proficient in Microsoft Office or Google applications.
• Excellent communication and interpersonal skills
• Thorough knowledge of billing requirements and regulations of major payers.

Education, Knowledge, Skills and Abilities Preferred:

• Bachelor's degree.
• Experience in healthcare.
• Knowledge of Managed Care contracts, Medicare, and Medicaid.
• Proficient in SMS, Epic and/or other hospital billing systems.
• Knowledge of ICD-9/10 and medical terminology.

Licenses and Certifications Required:

• Certification or Proficiency in Epic HB Fundamentals within 6 months of hire.
• Certification or Proficiency in Epic HB Insurance Follow-Up within 3 months of hire.
• Must successfully pass completion of EPIC assessment within 30 days after Network access granted.

Licenses and Certifications Preferred:

• Certified Revenue Cycle Representative

If you feel the above description speaks directly to your strengths and capabilities, then please apply today! Compensation Minimum rate of $73,153.60 Annually HMH is committed to pay equity and transparency for our team members. The posted rate of pay in this job posting is a reasonable good faith estimate of the minimum base pay for this role at the time of posting in accordance with the New Jersey Pay Transparency Act and does not reflect the full value of our market-competitive total rewards package. The starting rate of pay is provided for informational purposes only and is not a guarantee of a specific offer. Posted hourly rates may be stated as an annual salary in the offer and posted annual salaries may be stated as an hourly rate in the offer, depending on the level and nature of the job duties and credentials of the candidate. The base compensation determined at the time of the offer may be different than the posted rate of pay based on a number of non-discriminatory factors, including but not limited to: Labor Market Data: Compensation is benchmarked against market data to ensure competitiveness. Experience: Years of relevant work experience. Education and Certifications: Level of education attained, including specialized certifications, credentials, completed apprenticeship programs or advanced training. Skills: Demonstrated proficiency in relevant skills and competencies. Geographic Location: Cost of living and market rates for the specific location. Internal Equity: Compensation is determined in a manner consistent with compensation ranges for similar roles within the organization. Budget and Grant Funding: Departmental budgets and any grant funding associated with the job position may impact the pay that can be offered. Some jobs may also be eligible for performance-based incentives, bonuses, or commissions not reflected in the starting rate. Certain positions may also be eligible for shift differentials for work performed on evening, night, or weekend shifts. In addition to our compensation for full-time and part-time (20+ hours/week) job positions, HMH offers a comprehensive benefits package, including health, dental, vision, paid leave, tuition reimbursement, and retirement benefits.

HACKENSACK MERIDIAN HEALTH (HMH) IS AN EQUAL OPPORTUNITY EMPLOYER

All qualified applicants will receive consideration for employment without regard to age, race, color, creed, religion, sex, sexual orientation, gender identity or expression, pregnancy, breastfeeding, genetic information, refusal to submit to a genetic test or make available to an employer the results of a genetic test, atypical hereditary cellular or blood trait, national origin, nationality, ancestry, disability, marital status, liability for military service, or status as a protected veteran.

Hackensack Meridian Health (HMH) is a Mandatory Influenza Vaccination Facility