Job Description:
Revenue Cycle Analyst:
This job description outlines a role responsible for overseeing a customer’s RCMS contract, ensuring the smooth functioning of the revenue cycle across multiple business accounts, and ensuring key performance indicators (KPIs) are met.
About the Role:
The ideal candidate should have advanced RCM knowledge, problem-solving abilities, and experience in resolving complex customer issues. They will collaborate with teams, lead billing operations, and report monthly performance.
Responsibilities:
- Oversee a customer’s RCMS contract
- Ensure the smooth functioning of the revenue cycle across multiple business accounts
- Ensure key performance indicators (KPIs) are met
- Collaborate with teams
- Lead billing operations
- Report monthly performance
- Responsible for providing oversight of a customer’s RCMS contract
- Ability to address multiple markets of business accounts
- Ensure the revenue cycle is processing appropriately and KPIs are within expected parameters
Knowledge & Application
- Exhibits advanced RCM knowledge
- Possess wide-ranging experience using in-depth professional knowledge, acumen, concepts, and company objectives to develop and resolve complex customer business requirements
- Provides solutions to issues in creative and effective ways, understanding the interrelationships of different EHR functionality and impacts
- Complexity & Problem Solving: Advises on or serves as advisor on complex customer issue analysis that requires evaluation of identifiable factors
- Devises solutions based on limited information and precedent and adapts existing approaches to resolve issues
- Uses advanced knowledge, evaluation, judgment, and interpretation to select the right course of action
- Assesses agency billing requirements, EDI files, and other RCM processes, seeks collaborative solutions, and prepares and presents recommendations
- Resolves concerns with team members with minimal support from leadership to ensure a productive revenue cycle
- Leads an identified effort of complex RCM billing and reporting requirements, seeks collaborative solutions, and prepares and presents recommendations
- Excellent written and oral communication skills
- Ability to think quickly and logically to ensure solutions are identified
- Strong attention to detail and follow-through skills
Duties and Responsibilities
- Maintain & coordinate billing operations and support actions with other team members
- Lead efforts in payer and industry research impacting customers’ businesses
- Coordinate with team members to ensure metrics are met for contracts assigned
- Maintain skills of Senior Billing Specialist; step in and help team members to maintain contractual KPIs
- Monitor accounts for KPI performance and escalations
- Creation of month-end reporting and submission to provider practices
- Assist in process development
- Substantial understanding of medical billing, revenue cycle, and application of knowledge and skills to oversee customer contract(s)
- Identify trends, root causes, and design solutions with minimal leadership support
Qualifications:
- Bachelor’s degree and 6–8 years of medical billing experience
- Excellent Excel skills
- Ability to identify trends and design solutions independently
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.
Skills Required
- Bachelor's degree
- 6-8 years of medical billing experience
- Excellent Excel skills
- Ability to identify trends and design solutions independently
- Advanced revenue cycle management knowledge
- Experience resolving complex customer business requirements and issues
- Excellent written and oral communication skills
- Strong attention to detail and follow-through skills
What We Do
Qualifacts' CareLogic Enterprise Software is a comprehensive Electronic Health Record (EHR) designed for behavioral health, mental health, & human services.
