Revenue Analyst 2, Zero Balance

About Us :

Our purpose is to help clients exceed their financial health goals. Across the reimbursement cycle, our scalable solutions and clinical expertise help solve programmatic needs.

Enabling our teams with leading technology allows analytics to guide our solutions and keeps us accountable achieving goals.

We build long-term careers by investing in YOU. We seek to create an environment that cultivates your professional development and personal growth, as we believe your success is our success.

JOB SUMMARY :

The Revenue Analyst role consists of thorough and extensive analyzation and investigative assessment of claims that have been identified as paid incorrectly.

Through phone and written correspondence with insurance companies, the Revenue Analyst initiates pursuit of incorrectly paid medical insurance claims.

ESSENTIAL DUTIES AND RESPONSIBILITIES :

Note : The essential duties and responsibilities below are intended to describe the general duties and responsibilities of this position and are not intended to be an exhaustive statement of duties.

This position may perform all or most of the primary duties listed below. Specific tasks, responsibilities or competencies may be documented in the Team Member’s performance objectives as outlined by the Team Member’s immediate Leadership Team Member.

• Independently, consider business needs and adjust workflow accordingly when reviewing and researching available accounts for potential payer underpayments to pursue.
• Analyze and ascertain pertinent information from multiple sources (e.g., hospital systems, medical records, claims) to identify true causality for underpayments.
• Recognize payor and client trends and perform research to maximize profitability.
• Consider account profitability and cost analysis when reviewing for potential rebills.
• Analyze payer contracts for revenue risks when business needs arise.
• Facilitate and communicate results of rebills with auditors.
• Mentor and assist with onboarding of incoming Revenue Analysts.
• Coordinate and lead training for incoming team members.
• Facilitate and or annotate internal team meetings.
• Collaborate with manager and project leads to perform client work as assigned.
• Manage multiple internal projects while adhering to deadlines and weekly goals.
• Other duties as assigned.

MINIMUM QUALIFICATIONS & REQUIREMENTS :

• Associate’s Degree or 3-5 years relevant work experience preferred
• Knowledge of Revenue Cycle industry preferred
• Experience reviewing hospital claims and payor contracts
• Professional experience communicating with insurance companies verbally and writing complex appeals for contractual underpayments
• Comprehension of key risk areas of contract reimbursement methodologies
• Ability to conduct research via multiple channels (internet, client and payer systems, and internal resources
• Ability to navigate Hospital’s optical storage and patient accounting systems
• Critical thinking and decision-making skills
• Must be able multi-task and remain diligent with workload / multi-project while maintaining strong attention to detail
• Excellent written and verbal communication skills
• Strong computer skills, including OneNote, Word, Excel (advanced formulas, pivot tables)
• Ability to adapt to mentee learning style and adjust training accordingly
• Strong independent work ethic while also collaborating with a team to achieve goals

PHYSICAL DEMANDS :

Note : Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions as described.

Regular eye-hand coordination and manual dexterity is required to operate office equipment. The ability to perform work at a computer terminal for 6-8 hours a day and function in an environment with constant interruptions is required.

At times, Team Members are subject to sitting for prolonged periods. Infrequently, Team Member must be able to lift and move material weighing up to 20 lbs.

Team Member may experience elevated levels of stress during periods of increased activity and with work entailing multiple deadlines.

A job description is only intended as a guideline and is only part of the Team Member’s function. The company has reviewed this job description to ensure that the essential functions and basic duties have been included.

It is not intended to be construed as an exhaustive list of all functions, responsibilities, skills and abilities. Additional functions and requirements may be assigned by supervisors as deemed appropriate.