Revenue Cycle Analyst

Job Description:

Qualifacts is a leading provider of behavioral health software and SaaS solutions for clinical productivity, compliance and state reporting, billing, and business intelligence. Its mission is to be an innovative and trusted technology and end-to-end solutions partner, enabling exceptional outcomes for its customers and those they serve. Qualifacts’ comprehensive portfolio, including the CareLogic®, Credible™, and InSync® platforms, spans and serves the entire behavioral health, rehabilitative, and human services market supporting non-profit Certified Community Behavioral Health Clinics (CCBHC) as well as for-profit large enterprise and small business providers. Qualifacts has a loyal customer base, with more than 2,500 customers representing 75,000 providers serving more than 6 million patients.  Qualifacts was recognized in the 2022 and 2023 Best in KLAS: Software and Services report as having the top ranked Behavioral Health EHR solutions.

About the Role:

Revenue Success 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. 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

Duties:

• 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

• 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 4–6 years of medical billing experience

• Excellent Excel skills

• Ability to identify trends and design solutions independently

Required Skills:

• Advanced RCM knowledge

• Problem-solving abilities

• Experience in resolving complex customer issues

This is an onsite position, 5 days/week, in the Vadodara office working the NIGHT SHIFT. Hours are 6:30pm-3:30am IST. Remote applicants will not be considered. 

Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.