Revenue Cycle Analyst - Lead

Job Number 52735
Posted 3/4/2019
Account Northern Light Health Home Office
Department Revenue Cycle
Location |ME| Northern Light Health Home Office - One Cumberland Place, Ba, ME 04401
Schedule Regular Full-time
Shift Day
Hours 8:00 - 4:30
Job Details Job Summary:

The role the Revenue Cycle Analyst is to assist EMHS organizations in identifying and implementing process improvements in an effort to operate a "best in class" revenue cycle. This position serves in a key role to improve the overall effectiveness of revenue cycle policy, practices and technology platforms for all EMHS organizations.

The Revenue Cycle Lead Analyst is an analytical and process improvement lead role in identifying and implementing process improvements in an effort to operate "best in class" revenue cycle across all members in EMHS system without reducing quality or service. This position serves in a key role to improve the overall effectiveness of revenue cycle policy, practices and technology platforms for all EMHS organizations. The primary responsibility of this role is to serve as an internal Analyst with strong financial, health care acuity and the ability to provide accurate analysis and clearly share results to management. Strong communication skills are required. This role will analyze complex data including clinical and financial data and transform to relevant information. In addition this role will serve in the areas of process improvement, organizational development, change management, performance monitoring, and other analytical needs. They will serve as a project facilitator, lead change analyst and will apply influential techniques to lead teams toward best practice solutions

The Revenue Cycle Lead Analyst will focus on system-wide process, technology, controls and key personnel that must be coordinated to achieve revenue integrity, compliance and customer satisfaction. These tactics may involve the need to: gather requirements, analyze findings, design solutions, write specifications and implement new and improved processes and recommend ongoing controls and protocols as well as other broader and unique tasks. Effectiveness of this position shall be measured in terms of assisting teams to achieve financial and other tactic, high quality output, and customer service satisfaction.

It is critical that this position be highly effective in delivering the services described in the Duties and Responsibility and work harmoniously with staff in the various revenue cycles across EMHS. Effectiveness will be measured in terms of results, commitment to EMHS and customer satisfaction (at all levels).

This position is a member of the EMHS Revenue Cycle team. Duties may be changed or reassigned by the Chief Revenue Officer as need arises.

Job Functions and Duties:

The Lead Analyst is responsible for managing and coordinating operations and workflow processes for areas identified across all members of EMHS. This role will collaborate with their customers to help achieve goals that are efficient, increase revenue, and minimize costs. This position will incorporate the organization's mission, vision and values into all staff development practices and all departmentally directed activities.

  1. Review and analyze revenue cycle functions (scheduling, registration, pre-certification, eligibility verification, charge capture, documentation, coding, claims editing, claims filing, patient billing, payment posting) to identify fragmented process and make recommendations for improvement.
  2. Assists with reconciliation tools for general ledger and program strategy results/strategic ledger
  3. Assists in the design, implementation and system support of business intelligence, decision support and communication applications
  4. Assist in providing gap analysis between actual and targeted future state.
  5. Applies appropriate tests to analytical results to provide high quality and accurate results
  6. Leads in data interpretation, communication and presentations around key performance indicators
  7. Presents relevant analytical data to system teams to aid in telling a story that allows leaders to in make decisions and measure results.
  8. Serves as a project facilitator for teams working on major, complex performance improvement efforts.
  9. Assists with reviewing current processes with customers
  10. Leads root cause analysis to understand the business issues and summarize data challenges of the customer
  11. Communicates status updates, feedback, areas of improvements based on review strengths and weaknesses relating to business processing which may include senior and executive management.
  12. Provides support for inquiries or issues related to improvement. Researches, diagnoses and resolves problems and infrequently escalates to manager.
  13. Helps with the development of standardized and consistent metrics for system wide initiatives
  14. Assists with analyzing the numbers and quantifying objectives
  15. Contributes to development of templates and communication. Leads educational events to ensure consistency between teams
  16. Identify and assist in remedying communication issues
  17. Link other teams for collaboration and eliminate overlap
  18. Assist with special analysis and projects as needed.
  19. Coordinate a collaborative process for the development of policies and procedures.

20. Work collaboratively with managers / directors to identify best practices and help develop performance standards that can be tracked and reported.

21. Mentors staff in support of successor ship planning.

22. Assists manager/directors in project assignment and completion by analyst team as needed.

23. Perform other duties as assigned.

  1. Seek and recommend new information technology solutions and or manual changes that support revenue cycle functions.
  2. Work collaboratively with departmental personnel to implement systems and process change aimed at revenue cycle performance.

Management Reporting and Monitoring
  1. Review and analyze on-going revenue cycle performance based on computer generated data and manual reports (ATB'S, Days in A/R, Bad Debt Turnover, Contractual allowances, claims denials, late charge activity, accounts discharged/not final billed, Charity Care write offs and other deductions to Revenue).

Training & Education
  1. Educate departments and operational areas regarding the impact of their department on the revenue cycle in the areas of timely charging, internal controls over charges, charge master maintenance, documentation requirements, coding, payment methodologies, etc.
  2. Work closely with operational directors and managers to identify common areas of deficiencies and create training sessions to correct the noted deficiencies.

Professional Development
  1. Attend local, regional and national conferences/seminars to remain current in supporting the needs of revenue cycle activities.
  2. Reviews Third Party Regulatory publications to maintain knowledge base concerning compliance, billing requirements, reimbursement and coverage issues. Will distribute notifications of all changes in billing requirement/coverage issues to the appropriate clinical department head or support staff.
  3. Maintains current knowledge of regulatory developments involving agencies such as (HCFA, MHDO, DHS, and Joint Commissions)

Note: the duties listed above reflect the majority of the duties of this job and does not, nor is it intended to, reflect all duties that may be required for an incumbent in this job to perform.

Education and Experience:

· Bachelor's degree required. Eight years of progressive, relevant knowledge toward mastery in the field accepted in lieu of Bachelor's degree.

· Five or more years of progressively responsible experience in revenue cycle operations.

· Experience with EMHS Software, data and business information is preferred.

· Working knowledge of Medical Terminology, Current Procedural Coding (CPT, HCPCS), Diagnostic Coding (ICD-9, ICD-10), and HIPAA ANSI codes.

· Working knowledge of Microsoft Office, Excel, Access, Siemen's, Monarch, Allscripts, Meditech, and other Revenue Cycle systems.

· Demonstrated experience in diagnosing, evaluating and developing corrective actions for problems in Revenue Cycle Operations.

Licenses and Certifications:

· Certified Revenue Cycle Professional certificate within one year of employment.

Knowledge, Skills, and Abilities:

· Detailed knowledge of Revenue Cycle, reimbursements, data streams, and auditing principles.

· Demonstrated experience in gathering, diagnosing, evaluating and developing corrective actions for problems in revenue cycle operations.

· Knowledge of business analysis techniques required.

· Working knowledge of all functional areas of the revenue cycle, including contract and denial management, CDM and charge capture management, contract terms and requirements, and strategic pricing.

· Expertise with regulations and accreditation standards, knowledge of specific state and federal requirements and standards as it relates to modern Revenue Cycle systems.

· Working knowledge of Medical Terminology, Current Procedural Coding (CPT, HCPCS), Diagnostic Coding (ICD-9, ICD-10), and HIPAA ANSI codes (remark and adjustment codes).

· Excellent communications skills, both oral and written.

· Intermediate Microsoft software knowledge and ability to train/assist end-users.

· Ability to interpret an extensive variety of instructions furnished in written, oral, diagram, or schematic form.

· Ability to effectively influence change.

· Flexible and able to react to ever changing priorities.

· Experience with EMHS Software, data and business information is preferred.

Travel Requirements:

· 15 – 50% travel may be required.

· Employee must have a valid drivers' license and possess own transportation.

Equal Opportunity Employment
We are an equal opportunity, affirmative action employer and all qualified applicants will receive consideration for employment without regard to race, color, religion, age, disability status, gender, sexual orientation, ancestry, protected veteran status, national origin, genetic information or any other legally protected status.