Revenue Cycle Analyst

Revenue Cycle Analyst - Insurance

Assists in overall general daily operations of Patient Accounts Department. Exhibits exemplary customer service skills when dealing with co-workers, the public and any associated vendors, payers or department heads. Assists in finding solutions and resolution to claim underpayments or denials, and assists team members in all aspects of the process.

• Responsible for the payment posting, timely billing and follow-up on all assigned accounts until paid or adjusted according to policies.
• Analyze account history to expedite payment and improve cash flow.
• Follow up with payers, as necessary, regarding the collection of past due accounts; minimum 45 claims or dates of service per day.
• Communicates effectively with director as needed to report problems and provide follow-up on status.
• May assist in preparing documents, spreadsheets or reports as requested.

Duties:   

• Assures claim batches and payment processing is performed within departmental guidelines and works directly with director and co-workers to meet protocols, procedures and daily expectations of department.
•  Work with accounting staff on daily cash reconciliation.
• Regularly meets with team and director to discuss problems, work flow issues and general departmental concerns.
• Possess in depth knowledge of HIPAA standards, compliance and follows appropriate reporting procedures.
• Regularly monitors reports for compliance with expected standards.
• Assists with client statement issues as needed.
• Initiate billing on assigned claims in an expeditious manner through electronic format. Audit claims to ensure pertinent information is captured, including authorizations, clinical notes, treatment plans etc.
• Maintain control of claims billed and pending to ensure full accountability for all assigned accounts.
•  Follow-up on all unpaid claims over 30 days. Analyze aging reports to identify details of open account balances. Maintain documentation of all collection activity.
• Advise director of workload problems which may prevent timely follow up on accounts.
• Weekly tracking of unbilled claims. Notify director of trends/issues.
• Work EOB/ERAs on a daily basis to identify denials or short paid claims.
• Work with other departments on eligibility issues and necessary documentation to ensure timely collection of accounts.
• Demonstrate professionally aggressive yet conscientious collection efforts.
• Submit to director for approval all account adjustments as appropriate.
• Submit completed refund request documentation to director within policy guidelines.
•  Resolve credit balance accounts on a monthly basis.
• Perform all other duties as assigned by director.

This position should have sufficient preparedness in the following areas:

• Extensive knowledge of healthcare insurance billing.
• Exceptional understanding of payor-specific billing guidelines.
• Knowledge of Excel, Word, and other IT systems relevant to the organization’s work flow.
• Exceptional Medical terminology and coding knowledge.
• HCFA and UB knowledge.

Benefits include:

• 9 paid organization-wide holidays
• 1 paid personal holiday
• Accrued PTO
• Medical, dental, and vision insurance plans
• Employer match toward 403(b) retirement savings account for eligible employees
• Employee assistance program for free or reduced financial counseling, mental health counseling, and other confidential professional assistance
• As a 501(c) (3) nonprofit organization, Skyland Trail is a Public Service Loan Forgiveness (PSLF) qualified employer. Full-time employees may qualify for the federal student loan forgiveness program

Workplace Culture:

Skyland Trail is a nonprofit mission-focused organization with five campuses in Atlanta and about 250 employees. Employees work collaboratively in small teams. Cross-departmental committees and working groups help ensure quality and performance improvement. Each and every employee plays an important role in our clients healing and recovery.

Skyland Trail respects and values individuals and their diverse histories, abilities, identities, and perspectives. We work to ensure all aspects of our organization reflect our commitment to diversity, inclusion, and cultural equity.

• High School graduate or equivalent.
• 5+ years related experience in a high-volume healthcare setting with health insurance billing and AR related duties.
• Mental health billing experience preferred.
• Remote work opportunity available.