Sr. Revenue Cycle Analyst - Full-Time - 40 hours per week.
- Monday-Friday, 8am-5pm
- Location: Downers Grove, IL or Quincy IL.
- Work Schedule: Hybrid
Responsibilities: - Gathering and interpreting data from multiple systems and sources
- Financial modeling of impact of proposed initiatives and tasks
- Financial analysis of performance on prior initiatives
- Manage revenue cycle programs such as claims projects, patient engagement and contracted rate variances
- Creation of policies to improve contract performance by analyzing denials, underpayments, underperformance of service lines or procedures, physician performance, site level economics and vendor performance
- Develop financial impact and cost models using healthcare claims, EMR data, internal and external referrals, payer contracts, financial class groupings, diagnosis coding on billed and paid claims, to predict financial results from Operations and RCM programs and initiatives. This includes identifying actionable items that would change processes or procedures to maximize performance.
- Translate workflow and best practices into system needs and inputs for Technology Team
- Work closely with IT/Data infrastructure leads to implement tools to develop a flexible analytics environment. Including but not limited to:
- Implement open source tools such as R or Python
- Creating data tables that combine clinical EMR data with paid claims data and demographic information for model building
- Validate model results
- Develop team members' business knowledge and peer review all results released
Qualifications:The Experiences You Bring- Bachelor's degree preferred.
- Knowledge of healthcare reimbursement methodologies strongly preferred
- A minimum 2 years of healthcare reporting experience
- Prior experience with the health care claims process and electronic claims payment systems such as Epic Tapestry or health plan claims experience Industry knowledge of ICD-10, CPT, HCPC coding
MINIMUM KNOWLEDGE, SKILLS, AND ABILITIES (KSA): - Strong critical thinking and analytical / problem solving skills, comfortable with complex calculations and strong attention to detail.
- Advanced proficiency in Microsoft Office, SQL, and R or Python.
- Exceptional written and oral communication skills
- Understand professional, ancillary and institution medical claims reimbursement methodologies
- Experience working with paid medical claims data
- Demonstrate the ability to deal with the changing environment and to lead/facilitate and manage change efficiently and effectively where appropriate
- Knowledge of healthcare contract provisions and the implications for reimbursement
The compensation for this role includes a base pay range of $60k-128k, with the actual pay determined by factors such as skills, experience, education, certifications, geographic location, and internal equity. Additional compensation may be available through shift differentials, bonuses, and other incentives. Base pay is only a portion of the total rewards package.
