Senior Revenue Data Integrity Analyst - Department of Revenue Integrity

 •  Wake Forest Baptist Health Winston-salem, NC

8 - 10 years experience  •  Healthcare IT

Salary depends on experience
Posted on 08/16/17
8 - 10 years experience
Healthcare IT
Salary depends on experience
Posted on 08/16/17

Job Summary: Works within the Corporate Revenue Cycle - Department of Revenue Integrity. Responsible for management of direct reports, assessing, directing and coordinating all aspects of data integrity within the corporate revenue cycle. Skilled in EPIC report generation that supports financial functions, charge capture, claim submission, denials and other aspects to ensure that Wake Forest attains optimal revenue integrity. Responsible for directing others in the creation of reports that support revenue integrity as well as managing the workload of each analyst.

Education / Experience:Bachelor's degree in Information Systems/Computer Science, Business Administration or Statisticsrequired. Ten years of directly appliedexperience may be substituted in lieu of the educational requirement. A minimum 5 years' healthcare revenue cycle analytics experience. Minimum 3 years' EPIC financialreporting experience. Two or more years of experience using the Business Office Enterprise (BOE) framework and data warehouse. Prior Patient Financial Services experience as a biller, cash control, denials management or other PFS function. Proven ability to perform data analytics and root cause analysis.

Licensure, Certification, and/or Registration:LeanSix Sigma Certification (Green or Black level). EPIC Certifications (or enrolled in certification for completion within 12months of hire) for Resolute Billing, ADT and/or Clarity reporting.

Essential Functions:

1. Performs in-depth analysis of workflow and business operations working closely with front and back end users from the operational departments impacted by EPIC. Understands how work flow decisions translate to application configurations and uses this to further reporting and data analytics

2. Collects, interprets, and documents specifications required to develop new or existing CRC processes.

3. Assists with developing departmental program planning, strategy, and goals for increased revenue reimbursement. Analyzes business process to identify possible inefficiencies and makes recommendations to improve procedures to optimize reimbursement. Creates reports based on analytics that act as a control to mitigate future recurrences.

4. Demonstrates knowledge of the organization's core values and incorporates them into the performance of duties. Performs and participates in other related duties as required.

5. Assists with developing departmental program planning, strategy, and goals for increased revenue reimbursement. Analyzes business processes to identify possible inefficiencies and makes recommendations to improve procedures, prevent future cash losses and to optimize reimbursement.

6. Performs data collection, tracking and analytical duties to respond to key issues, increase reimbursement and process efficiency and in support of the decision making process of leadership from multidisciplinary perspectives. Data mines from hospital information systems, and runs reports as requested to find opportunities for revenue generation. Investigates and documents any potential for new program and product development and documents all results and recommendations.

7. Responsible for the ongoing development and reporting of executive summaries and detailed key practice indicators and performance metrics, as well as various ad hoc data requests - all in a professional format with the goal of optimizing receivables performance. Ability to track and report the percentage of generated revenue and overall improvement related to any new initiative.

a. Both routine and ad hoc reports are delivered with detail to respond to most anticipated questions.

b. Monthly and in a timely manner, reports are prepared for and delivered to Revenue Cycle administration and executive level. Follow up requests from recipients are responded to courteously, immediately and with detail and accuracy WFBMC expects and signifies.

8. Manages direct reports to ensure the highest efficiency in report writing and analytics. Creates an "organic" growth plan of ongoing EPIC education and certifications to ensure that the analytics are considered "best of breed" for the EPIC users group.

This job description is an overall statement of responsibilities of this position. The incumbent may be requested to perform other related duties other than those described herein.

Skills & Qualifications:

  • The successful applicant will have demonstrated performance improvement experience in an EPIC financial/hospital environment. Will demonstrate successful data analysis, investigation of a potential concern, creation of a Pl plan of action in conjunction with the Pl team with demonstrated successful remediation using LeanSix Sigma 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

Work Environment:

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

Job ID: 22467

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