Revenue Cycle Analyst

Benefits:

• Health insurance
• Paid time off
• Parental leave
• Profit sharing
• Training & development
• Vision insurance
• Wellness resources
• 401(k)
• Competitive salary
• Dental insurance
• Employee discounts

Revenue Cycle Analyst-FT
Maple Grove, MN
This position will report in our Corporate Office 2 days a week

PRIMARY OBJECTIVE:

Research and provide data analysis on revenue generating lines of business such as third party contract management, U&C/retail pricing, discount cards, and 340B. Navigate and operate SQL as well as Thrifty White technology to fully research and resolve issues related underpayments, payment discrepancies, and provide insight/solutions for mitigating strategies. Maintain positive professional relationships with third party payers, hospital partners and vendors.

MAJOR RESPONSIBILITIES:

Specialist
• Provide Manager/Director with data analysis reporting on various LOBs.
• Use SQL queries to develop reporting to identify potential payment errors and/or contractual payment discrepancies.
• Work with third party payers (Optum, Caremark, ESI etc.) when discrepancies are found or to research claims
• Perform analysis on GER/BER/PLC charges and validate accuracy.
• Use technology to ensure claims are billed appropriately.
• Review and report on reimbursement trends
• Create and maintain 3rd party payor dashboard for executive review
• Review 340B accounts to identify missed opportunities/need to recontract.
• Review 340B account budget vs actual on monthly basis and provide analysis.
• Manage relationships with 340B hospital partners and TPAs (Macro Helix, Sentry etc.)
• Perform all other job duties as assigned.

MINIMUM QUALIFICATIONS

Education, Experience, Skills and Abilities:
• AAS Degree or equivalent.
• 2-3 years' experience with data analytics
• Excellent verbal and written communication skills, including the ability to communicate with customers, A/R team members, internal and external partners, and leadership.
• Exceptional follow through to ensure work is done correctly the first time.
• Background and familiarity of pharmacy insurance processing. If background does not exist, must be able and willing to quickly pickup new knowledge and apply it quickly.
• Proficient computer skills, including Word, Excel, Outlook, SQL and more.
• Strong desire and ability to look at processes with a fresh perspective to drive improvements and efficiencies.
Ability to:

o Troubleshoot and problem solve using all tools and resources available prior to escalating the issue

o Turn projects around quickly when requested from Manager/Director/Executive Leadership

o Operate phones and copy/print/scan machines

o Prioritize, multitask, and manage workload

o Maintain effective working relationships with third parties, partners and leadership

o Maintain confidentiality

o Must have the ability to have and maintain a clear record without exclusion, sanctions or debarments with the Office of the Inspector General at the time of hire and monthly thereafter.

DESIRED QUALIFICATIONS
• Insurance and/or pharmacy experience
• Knowledge of PeopleSoft, Microsoft Office, TWRX, SQL, and OnBase
• If these desired qualifications do not exist, there must be a drive and ability to quickly learn new things, especially within these areas

PHYSICAL DEMANDS:

The physical demands described here are representable of those that must be met by an employee to successfully perform the essential job functions of this job. Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions.

This position involves in-office work and may include long periods of sitting. While performing the duties of this job, the employee is also frequently required: to stand, talk and hear, use hands and fingers, handle, or operate objects, tools, or controls, and to reach with hands and arms.

The employee must occasionally lift and/or move up to 40 pounds. (Review the "Safe Lifting Techniques" policy). Specific vision abilities required by this job include close vision, distance vision, peripheral vision, color vision, depth perception, and the ability to adjust focus.

We offer competitive wages, medical, dental, vision, life, 401k, Employee Stock Ownership Plan, paid holidays and vacations, and a store discount for you and your family.

Flexible work from home options available.

Compensation: $95,000.00 - $105,000.00 per year