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Revenue Cycle Analyst

Faculty Practice Organization

Revenue Cycle Analyst

  • 530186
  • New York
  • Faculty Practice Organization
  • Full Time
  • Opening on: Oct 7 2022
  • Grade 105
  • Job Type: Officer of Administration
  • Regular/Temporary: Regular
  • Hours Per Week: 35

Position Summary

The Revenue Cycle Analyst provides analytic support, problem-solving, and communication with clinic departments on all matters pertaining to revenue cycle needs and key operating indicators (KOIs).


Responsibilities

Technical 78%

  • Reviews and analyzes “Explanation of Benefits” (EOBs), payer correspondences to identify denials that can be appealed. Perform denials analysis to reduce controllable rejections.  Perform deep-dive analysis to find solutions that can benefit multiple specialties.
  • Extracts, collates, and refines data from multiple sources to manipulate into one reporting set using excel, BI tools, and other practice management systems.
  • Stay abreast of group payer contracts, payer policies, payer plans, and member benefits. Conduct audits and analysis, identify revisions and changes that impact stakeholders.  Prepares communication plan for audit results and information discovered to relevant stakeholders.  Participates in developing best practices for relevant changes.
  • Present data, analysis, and recommendations for solutions in meetings with departmental management and other stakeholders.  Participates in training and other in-servicing sessions for end-user education.
  • Develop new report templates for ad-hoc and or standard monthly reports to assist with monitoring of Revenue Cycle Metrics. Provides a detailed assessment of revenue cycle processes with a focus on process improvement and best practices. Monitor and analyze to compare with industry benchmarks
  • Prepares monthly reports, analyses, and formal presentations for departmental and central administration leadership. Delivers presentations as needed.
  • Applies knowledge of coding including use of billable CPTs, diagnosis codes, modifiers, place of service codes, and source codes to perform an in-depth analysis of root cause issues. 
  • Works closely with Department management to facilitate root issue remediation.
  • Collaborates closely with peers to develop, validate, and maintain meaningful report sets. Recommends and implements best practices within the CRO and departments. 

Strategic 10%

  • Monitor ongoing performance of Revenue Cycle results through the use of key operating indicators (KOI).  Use data to identify trends and gaps.  Uses dashboards and reports to monitor keep performance indicators of revenue cycle workflows and to ensure a holistic view of the revenue cycle.
  • Identifies key topics and best practices for optimization and establishes mechanisms to share expertise and knowledge amongst peers.   

People 6%

  • Cultivates effective collaborative relationships with academic departments and other subject matter experts (SME) to seek resolution of issues identified through monthly monitoring of KOIs/KPIs. 
  • Serves as liaison between CRO – Revenue Cycle Management team and the clinical departments in the coordination of revenue cycle projects and activities.

Compliance and Other 6%

  • Represents the CRO Management Team on committees, task forces, and workgroups.  Negotiates workable compromise solutions to complex problems between the FPO, CRO and other departments, outside vendors, etc.
  • Conforms to all applicable HIPAA, Billing Compliance, and safety policies and guidelines.
  • Performs other duties and responsibilities as assigned by the Chief Revenue Cycle Office and Directors of the CRO.

Minimum Qualifications

  • Requires bachelor’s degree or equivalent in education and experience.
  • Minimum of 4 years related experience in physician billing and third-party payer reimbursement.
  • An equivalent combination of education and experience may be considered.
  • Advanced skills in using excel and BI data applications to maneuver through large volumes of data.
  • Strong verbal and written communication skills.
  • Ability to work independently and follow through and handle multiple tasks simultaneously.
  • Must be a motivated individual with a positive and exceptional work ethic.
  • Proficiency in health insurance billing, collections, and eligibility as it pertains to commercial, managed care, government, and self-pay reimbursement concepts and overall operational impact.
  • Strong knowledge of electronic billing systems for front-end and back-end functions and the willingness to learn new systems, applications, and programs.
  • Advanced proficiency in data extractions (DBMS & Data Warehouse Tools) and use of business analytic applications.
  • Demonstrated advanced skills in A/R management, problem assessment, and resolution, and collaborative problem-solving in complex, interdisciplinary settings. Excellent analytical skills: attention to detail, critical thinking ability, decision making, and researching skills in order to analyze a question or problem and reach a solution.
  • Ability to work collaboratively with a culturally diverse staff and patient/family population, strong customer service skills, demonstrating tact and sensitivity in stressful situations.
  • Must successfully complete systems training requirements.

Preferred Qualifications

  • Experience with GE/IDX, EPIC, Experian, and Cognos is preferred.

Other Requirements

Patient Facing Competencies

Minimum Proficiency Level

Accountability & Self-Management

Level 3 - Intermediate

Adaptability to Change & Learning Agility

Level 3 - Intermediate

Communication

Level 3 - Intermediate

Customer Service & Patient-Centered

Level 3 - Intermediate

Emotional Intelligence

Level 3 - Intermediate

Problem Solving & Decision Making

Level 3 - Intermediate

Productivity & Time Management

Level 3 - Intermediate

Teamwork & Collaboration

Level 3 - Intermediate

Quality, Patient & Workplace Safety

Level 3 - Intermediate

Leadership Competencies

Minimum Proficiency Level

Business Acumen & Vision Driver

Level 2 - Basic

Performance Management

Level 1 - Introductory

Innovation & Organizational Development

Level 2 - Basic


Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.

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