Revenue Cycle Analyst
Job Title: Revenue Cycle Analyst 2022
Reports To: Director of Revenue
Job Summary: Responsible for NextGen and other revenue cycle system and business operations support to include end user workflow support and education; NextGen system and billing support, training and re-training; NextGen system analytics, KPI reporting, system audits and QA. Assists Revenue Cycle Director in improving revenue cycle operations and the financial strength of CCHCI. Part of Revenue Integrity Team which includes Special Projects. This employee is a necessary and integral part of Revenue department and will be guided by The Revenue Director and assigned projects both on an urgent need basis and for long term analysis. This role cannot be filled by an outside department.
Qualifications and Requirements:
To perform this job successfully, an individual must be able to perform each essential job duty satisfactorily. The requirements listed below are representative of the knowledge, skill, and/or ability required. This job description in no way implies that these are the only duties to be performed and may be modified, interpreted and/or applied in any way as necessary. Maintaining regular and punctual attendance is required. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential duties.
Essential Job Duties:
- Revenue Cycle Operations, NextGen System Support and Training
- Performs the liaison role between Revenue Department and informatics, IT , Nextgen , OSIS and other departments and individuals who require adaptation of new procedures that directly influence changes in revenue practices.
- Revenue NextGen PM Subject Matter Expert for Revenue Cycle with intimate knowledge of billing and revenue practices including AR, Charge Entry, Coding, Contracting and Denials.
- Develops Revenue Processes in Nextgen which maximize revenue department’s contributions to quality measures with coding and charges.
- Identifies opportunities and creates Revenue Cycle processes that directly increases efficiency.
- Attends Nextgen operational meetings with OSIS, CCHCI Nextgen experts’ meetings, and Informatics and maintains direct relationship with personnel in Nextgen upgrades, migrations and CCHCI Nextgen training, etc.
- Performs daily upkeep, table entries, reports, and fine tuning of Nextgen input needed for Revenue Cycle
- Proven Expert in Nextgen Practice Management. Performs system testing, query writing, NextGen table and system maintenance, troubleshooting, documentation and training and resolution of application issues and reporting issues.
- Directly participates in system administration of NextGen for Revenue Cycle by reviewing and editing billable service items and other menu items and templates that affect billing including charge editing modules, payer tables, Nextgen contract library and any other proprietary software used with Nextgen or in Revenue Cycle.
- Ensures all staff are fluent and up to date in end user operational and NextGen system training/re-training and necessary certifications.
- Develops hands-on coaching, and other staff development tools and resources for all revenue cycle operating unit staff.
- Collaborate with IT on all projects requiring their input.
- Is in expert in Nextgen reporting using Nextgen analytics, to create task management, charge editing and event type analysis.
- Gathers and reports accurate data to facilitate and support leadership KPI requests, and internal and external audits, integrating with data from Informatics department as needed.
- Uses report and data expertise to enhance and plan revenue cycle improvements,
- Produces regular data and KPIS regarding coding processes, CPT 2 codes, RAFS and correlation of DX codes with CPT code usage using internal data and reports from Nextgen.
- Conducts/participates and takes leadership in regular operational staff meetings and training programs.
- Assists in Maintaining Optimal Revenue Cycle System Support and Financial Strength of CCHCI
- Stays current with NextGen Practice Management best practices and makes recommendations for inclusion and helps implement new practices and software within CCHCI revenue cycle operations.
- Participates in CCHCI Nextgen meetings and internal trainings.
- Identifies new technologies to enhance revenue cycle operations and be the primary business support and champion for new technology implementations within revenue cycle.
Required Education, Experience, Certificates & Licenses:
- Associate's or bachelor’s degree in Business, Information Technology or related field required.
- NextGen PM certification and experience required.
- Five years in Experience in Billing/Revenue Department role required with a broad healthcare knowledge and terminology in all areas.
- Experience in Revenue Cycle and NextGen PM training and development activities.
- Three years of education and/or experience in a leadership role required, with an emphasis on data analysis and optimization of operating practices to meet best practice standards
- Project management experience, including facilitating and coordinating the activities of multiple workgroups, teams or organizational units.
- Driver's License and Proof of Insurance may be required if requesting mileage reimbursement.
- Valid Fingerprint Clearance Card.
Required Language Skills:
- Ability to comprehend and compose instructions, correspondence and communications in English in both oral and written format.
- Ability to effectively present information in one-on-one and small group situations to patients, internal providers and staff and other agency staff working in cooperation with the organization.
- Ability to occasionally exert enough force to move objects weighing up to 10 pounds.
- Ability to continuously remain in a stationary position.
- Ability to occasionally move about inside the workplace to access files, office machinery, etc.
- Possesses hand-eye coordination and manual dexterity necessary to constantly operate computer, telephone, and other office machinery.
- Possesses close visual acuity necessary to accurately record and view information on a computer monitor, handwritten and typed documents.
- Ability to discern the nature of sounds at a normal spoken volume.
Other Required Knowledge, Skills, and Abilities:
- Ability to add, subtract, multiply and divide in all measure, using whole numbers, common fractions and decimals.
- Ability to compute rate, ratio and percent and to draw and interpret graphs.
- Ability to skillfully gather and analyze data.
- Ability to perform a variety of assignments and make decisions requiring considerable independent judgment.
- Displays high level of critical thinking and problem-solving skills.
- Displays excellent multi-tasking, analytical, organizational and problem-solving skills
- Displays sound and accurate judgment and ability to make timely decisions and work under pressure.
- Knowledge of billing, medical records, medical office operations, health plans, and community health centers preferred.
- Knowledge of HIPAA and Corporate Compliance rules and regulations.
- Knowledge of Human Resources Policies and procedures and Employee Handbook.
- Advanced computer proficiency required with proficiency in use of all Microsoft Office programs.
- Knowledge of Electronic Health Records required.
- Ability to employ motivational techniques to train, mentor and lead staff.
- Demonstrated leadership skills with ability to build effective teams.
- Demonstrated ability to listen to divergent views and build consensus and support for a shared goal.
- Ability to prioritize and plan work, use time efficiently and develop realistic action plans.
Work Environment & Conditions:
- Work environment is usually typical of an administrative office setting with no substantial exposure to adverse environmental conditions.
- Work requires reliable transportation as position requires frequent travel and extended hours to include early mornings, evenings, holidays and weekends.
- Work requires ability to be contacted by cell phone during or outside of regular work hours.
Job Status: Full Time