Revenue Cycle Quality & Performance Management Analyst

Job Description

Analyzes, identifies and recommends and delivers plans and training materials throughout implementation and helps ensure smooth operations post-implementation. Serves as an operations consultant for Revenue Cycle Business Operations implementation and maintenance. Liaises between various project teams.

Job Responsibility

• Analyzes, implements, and maintains revenue cycle activities across sites and ensures goal setting and tracking. Makes recommendations for development and analysis of implementation plans for System development and implementation of Revenue Cycle Business Operations which may include discovery, design, conversion, testing, and/or any other components of the project plan cycle. 
• Serves as a liaison between business and technology teams. 
• Participates in developing and delivering training programs for current and prospective users. Educates practice, site and corporate management on Revenue Cycle Business Operations policies and procedures. 
• Assists implementation team in configuring HIPAA rules based on System policies and legal requirements. 
• Ensures processes are compliant with system policies, applicable laws and contractual bargaining agreements. 
• Develops procedures for system audits. Resolves discrepancies, as required. 
• Collaborates with implementation teams to resolve user issues. 
• Consults with departments to provide customer support during and post- implementation. 
• Troubleshoots issues and resolves concerns as well as recommends necessary fixes. Advises management of results and recommends actions. Consults with newly acquired facilities and designs transition and implementation plans. 
• Performs related duties as required.
• Operates under general guidance and work assignments are varied and require interpretation and independent decisions on course of action. 
• Performs related duties as required. All responsibilities noted here are considered essential functions of the job under the Americans with Disabilities Act. Duties not mentioned here, but considered related are not essential functions.
• Evaluates and interprets data, including EOB review, billing and reimbursement policies and provider linkages setup
• Analyzes underpayment trends, derives and presents related conclusions and recommendations for resolution
• Performs ad hoc reporting and analyses for various clinical and administrative departments
• Research and report on payer policies that affect reimbursement and other Revenue Cycle functions
• Assigns contractual rates for new and existing providers for delegated payers and reports discrepancies to management
• Assists in roster reconciliations to proactively identify and correct provider linkage issues

Job Qualification

• Bachelor's Degree required, or equivalent combination of education and related experience.
• 1-3 years of relevant experience, required.

Preferred Qualifications

• Excellent communication and reasoning skills.  Ability to multi-task and exercise sound judgment.
• Proficiency in Excel.
• Strong analytical skills.
• Ability to work with large sets of data.

*Additional Salary Detail 
The salary range and/or hourly rate listed is a good faith determination of potential base compensation that may be offered to a successful applicant for this position at the time of this job advertisement and may be modified in the future. When determining a team member's base salary and/or rate, several factors may be considered as applicable (e.g., location, specialty, service line, years of relevant experience, education, credentials, negotiated contracts, budget and internal equity).