OverviewOCCUPATIONAL SUMMARY – Revenue Integrity
Revenue Integrity Senior Financial Analyst requires a comprehensive understanding of general healthcare operations, standards and practices. It requires a high level of independent thinking. They conduct complex analysis and modeling to assist in the prevention of recurring issues that can cause revenue leakage and/or compliance risks. This position uses healthcare industry standards and practices to build analytical tools. It requires the analyst to have intermediate to advanced knowledge of the use of a variety of datasets and tools. Both qualitative and quantitative analytic are performed by the analyst to find and report on patterns, insights and trends used by decision makers. Areas of support include monitoring organization’s charging practices and capture, CDM build and maintenance support, programmatic pricing strategies development and compliance/program objective reviews. Independently responsible for work assigned by coordinator or manager. Will provide training and occasionally interacts with individuals throughout the organization.
Responsibilities
The Senior Financial Analyst is assigned projects by the Department Coordinator, Manager, or Director that require a comprehensive understanding of general health care operations, complex financial modeling and the ability to operate at a high level of independent thinking. Conducts complex operational and financial analyses and provides training and education in a mentoring relationship to lower-level financial analysts. Also assumes the coordination of large non-routine projects as assigned by the Department Coordinator, Manager or Director.
PRIMARY DUTIES AND RESPONSIBILITIES – Revenue Integrity
Produces actionable reports that show key performance indicators, identifies areas of interest and displays analysis of the study. Documents process used and communicates findings and insights.
Uses standard analysis tools and some advanced modeling. Integrates advanced understanding of program design and objectives in interpreting the results. Provides advanced level insights and recommendations regarding the findings.
Builds and uses more complex queries and processes to extract data.
Evaluates results for reasonableness against the provided requirements and program knowledge. Investigates and is able to address most inconsistencies found and documents data limitations.
Advanced understanding of Revenue Integrity, CDM, pricing strategies and reimbursement practices. Independently designs and builds reports using the most appropriate data elements.
Routinely arranges interdepartmental meetings to either gather or share information related to projects.
Trains analysts on standard healthcare concepts. Shares analytical tools and methods with the team and other colleagues.
Qualifications
REQUIRED
Bachelor's degree preferably in Finance, Economics, Accounting, Business, Public Health or Healthcare Administration or similar field
Four (4) years of experience in decision-making support role OR combination of experience and relevant advanced degree.
Experience in training/educating and mentoring others.
Experience in the development and management of complex project plans.
Skills in using Microsoft Office products; advanced level ability with Excel & Access applications.
PREFERRED
4+ years’ experience in healthcare finance role.
Master's in Business Administration, Healthcare Administration, or similar role.
Two years’ experience as a Healthcare Senior Financial Analyst or Consultant.
Strong knowledge of and experience with databases using SQL or other advance system languages. Adept at creating and managing complex queries.
Knowledge of CPT/HCPCS codes or experience in charging or performing charging validation reviews.
Strong analytical skills with the ability to collect, organize, and analyze significant amount of information with attention to detail and accuracy.
Demonstrated advanced executive-level professional communication skills in written reports and oral formats.
Experience with decision support products.
Experience with Standard Query Language (SQL).
Work Hours:7am - 3:30pm
Weekend Requirements:No
On-Call Requirements:No
