Technical Analyst - Revenue Cycle and Claims
Conquest Tech Solutions IncTX, United States3 days ago
Job type
- Full-time
- Part-time
- Temporary
- Quick Apply
Job descriptionWorks with stakeholders to discover, clarify, and document current and future data needs Performs mapping of revenue cycle, clinical and claims data to a normalized data model. Serves as a subject matter expert on the revenue cycle data domains such as Registration, Scheduling, Accounting and Billing, Cost Accounting and Claims Builds data concepts to support Revenue Cycle and Claims use cases Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions. Act as a quality consultant and subject matter expert, performing testing and validation of the mapping of data elements to standards Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues Works with customers to clarify and plan for their current and future technology needs. Determines and maps existing business processes / functions and recommends changes required to fit a tightly integrated system. Designs and implements projects requiring systems integration, small teams and multiple technical platforms. Conducts Return on Investment (ROI) and other financial analysis to support project funding / prioritization. Collaborates on driving improvement activities to achieve department and organizational goals. Coordinates with functional team to assure consistency and optimization of overall work product Assumes a proactive role in driving improvement activities to achieve department and organizational goals to deliver value. Maintains current knowledge of industry and business process trends and is able to apply that knowledge to existing business processes. Provides subject-matter expertise of Health Ministry processes, policies and requirements in support of functional area process design, testing and implementation Identifies opportunities for process improvement and makes recommendations that lead to improvements Monitors task assignments to ensure they are performed on schedule, within intended scope and to a defined level of quality. Escalates process and project issues that cannot be resolved Prior experience working as a Revenue Cycle analyst in the Healthcare system. Must have a working knowledge of relational databases / database structures, SQL expertise desired Must have a strong understanding of data collected and used in EMRs, Revenue Cycle and Patient Accounting Systems . Knowledge and experience with ambulatory and acute clinical, billing and claims workflows and clinical information systems. Bachelor or Masters degree in related health or finance field ex informatics or bioinformatics. Complexity of work : Within the scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision. Must be able to work in a stressful environment. 5 years of experience preferred
Title Technical Analyst - Revenue Cycle and Claims
Location Remote
Required SQL Proficiency (Intermediate to Advanced)
The experience we need goes beyond basic / sufficient levels. Candidates must demonstrate proficiency in the following :
- Common Table Expressions (CTEs) : Using the WITH clause to break down a complex query into smaller, readable, and reusable blocks.
- Subqueries : Proficiency in using nested SELECT statements (in the FROM, WHERE, and SELECT clauses) and knowing when to use them versus a JOIN.
- Advanced Joins : Deep understanding of all join types (INNER, LEFT, RIGHT, FULL), and the ability to join multiple tables (5+) correctly.
- Set Operations : Using UNION, UNION ALL, INTERSECT, and EXCEPT to combine results from multiple queries.
- Conditional Logic : Extensive use of the CASE statement for complex data categorization, pivoting, and transforming data based on business rules.
Job Summary
Responsibilities :
Experience :
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Revenue Cycle Analyst • TX, United States
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