CRC Performance Improvement Analyst - Revenue Integrity | Data Integrity

Salary depends on experience
Posted on 10/26/17
5 - 7 years experience
Healthcare IT
Salary depends on experience
Posted on 10/26/17

JOB SUMMARY:

 

The Performance Improvement Analyst works within the Corporate Revenue Cycle - Department of Revenue Integrity. The analyst will be responsible for assessing, creating six sigma performance improvement plans for all aspects within the corporate revenue cycle. Will work closely with charge capture and audit staff to create remediation plans using DMAIC or other consistently applied methodology with the front end and clinical departments. Will be responsible for on-going review and maintenance of the remediation and any corrective action steps required to ensure the performance improvement plan continues to create value and prevent revenue leakage. Will perform data collection, tracking and analytical duties to respond to key issues, increase reimbursement and process efficiency and in support of the decision making processes of leadership and the multidisciplinary teams. Investigates and documents any new potential program or program development. Will formulate corrective actions plans under the supervision of the Senior Performance Improvement Analyst and produce all necessary documents and recommendations. Provides education and trains staff on Revenue Cycle processes, EPIC workflows and workqueues and resultant competency testing that is relevant to corporate revenue cycle. Responsible for successful remediation of issues identified above.

EDUCATION/EXPERIENCE: Bachelor degree and five years of healthcare revenue cycle experience, including one year of preferred Epic experience; or an equivalent combination of education and experience.

LICENSURE, CERTIFICATION, and/or REGISTRATION: Lean Six Sigma Certification minimum of Green belt.

SKILLS & QUALIFICATIONS:

  • The successful applicant will have demonstrated performance improvement experience in a financial / hospital environment.
  • Will demonstrate successful data analysis, investigation of a potential concern, creation of a PI plan of action and demonstrated successful remediation using Lean Six methods.
  • Must have solid foundation knowledge of the revenue cycle processes, medical billing and coding processes, basic accounting principles, quantitative decision making and process analysis
  • Advanced computer analytical skills using Microsoft Office Suite of software
  • Ability to effectively establish/manage priorities and organize work structure in a fast-paced environment
  • Experience with creating education materials and training staff on Revenue Cycle processes and workflows
  • Must be patient centered in focus
  • Must have strong written and verbal communication/interpersonal skills to manage relationships and collaborate with all levels of management to include department directors and colleagues with varying professional backgrounds in the resolution of charge/revenue issues


WORK ENVIRONMENT:

  • Moderate noise environment
  • Cubical based office environment
  • Clean, well lit area
  • Comfortable climate

*TMJ

ESSENTIAL FUNCTIONS:


1. Demonstrates knowledge of the organizations core values and incorporates them into the performance of duties.

2. Assists with developing departmental program planning, strategy and goals for increased revenue integrity. Analyzes business processes, clinical processes, coding processes to identify possible inefficiencies and makes recommendations to improve procedures, prevent future losses and to optimize reimbursement based on compliant standards.

3. Performs data collection, tracking and analytical duties to respond to key issues, increase revenue integrity and process efficiency in support of the strategic initiatives and goals.

4. Responsible for ongoing development and reporting of executive summaries and detailed key performance improvement indicators with the development of performance metrics as a part of the plan.

5. Works collaboratively with clinicians, auditors, CRC administration to understand services provided to explore and capitalize on opportunities for enhanced revenue integrity (minimize charge leakage, maximize compliant reimbursement).

7. Data mines from hospital information systems, and runs reports as requested to find opportunities for performance improvement

21186

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