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Analyst

Company: UnityPoint Health
Location: West Des Moines
Posted on: May 3, 2021

Job Description:

This position is open to remote work within any of our UnityPoint Health regions.

The Revenue Cycle Integrity Analystis a key member of the Revenue CycleTeam reporting directly to the Director of Ambulatory Revenue Cycle Integrity. This position is responsible foridentifying trends,collaboratively working with leadership to producein-depthreportingthat will help improve therevenuecycle performance within the Ambulatory Clinics of UnityPoint Health (this includes clinicsoperated by UnityPoint Clinicand UnityPoint Health Hospitals). ThisAnalystwill be responsible for creating dashboards,managing and monitoring all aspects of the clinic related revenue stream. This role will have ongoinginteraction with clinic leadership, clinic revenue cycle staff, coding staff, billing staff, and IT teams.

This individual will focus on implementing and supporting continuous improvement in key revenue cycle functions including Registration, Coding, and Billing. TheAnalystwill maintain a goodworking relationship with allclinics to ensure clear communication and a collaborative approach to implementing best practice processes.


Revenue Cycle Improvement

  • Analyzes data to identifyopportunities for processimprovement.Applies analytic principles andis able toorganize, interpret andcommunicate data related to revenue integrity.
  • Develop and producereporting that will create accountability and drive change.
  • Develops and complete criticalRevenue Cycle projects bycollaboratingwith key stakeholders across UnityPoint Health.These projects affect business operations to a substantial degree.
  • Collects, monitors and analyzes data, and provides recommendations to clinic leadershipto drive better performance throughout the revenue cycle.
  • Responsible for decision making to improve and impact charge issues, complex claims processing workflows and regulations
  • Provides expert consultation to leadership as the subject matter expert for revenue cycle data.
  • Interprets existing revenue cycle policies and operating practicestomake recommendations for improvements.
  • Responsible for maintaining in-depth understanding of the entire revenue cycle. Responsible for troubleshooting registration, coding, and correct coding initiative (CCI) edits.
  • Research and resolve charge review, claim edit, and denial in assigned workques(WQ).
  • Liaison for the billing office team members. Answering questions and troubleshoot accounts as needed.
  • Maintainunderstanding of new rules and regulations related to billing.
  • Research new service line rules and regulations.
  • Responsible for self-monitoring of WQs and identifying potential charging issues.

Performance Monitoring/Revenue Integrity

  • Responsible for applying knowledge of revenue cycle principles to ensure accurate and compliant billing
  • Assists with collection, monitoring and analyzing data, and gives feedback to management for recommendations to leadershipto drive better performance throughout the revenue cycle.
  • Identifiesdifferent types of data that require tracking to improverevenue cycleperformance.
  • Develops easy-to-interpret reporting based on collected data and develops operating procedures in collaboration with clinic leadership to ensure continued monitoring.
  • Provides guidance and education to Revenue Integrity Specialistrelated to performance monitoring and revenue integrity functions.
  • Work withclinic leadershipto prioritize suggested changes.
  • Providestrainingas neededto improve operations.
  • Monitor revenue cycle KeyPerformanceIndicators and identifyareasof opportunityforimprovement andefficiency.
  • Drive change through data and collaboration with clinic leadership and staff.

Denials Management

  • Work with clinic leadership and staff to identify and remediate denials through rules and EMR build.
  • Produce reports that track performance and are easy-to-interpret.
  • Develop an understanding of complex rulesand regulations governing insurance, appeal activities, trends, etc. and make recommendations on system build to accommodate changes in these areas.
  • Develop an understanding of the entire revenue cycle and the factors that lead to denials and revenue loss.
  • Serves as the subject matter expert for leadership, peers and team membersfor denials management.

Education:

  • High School Diploma or GED
  • Bachelors degree in Healthcare Administration, Business, Mathematics or Computer Science preferred.

Experience:

  • 4 years of progressive experience in revenue cycle/medical billing
  • 2 years experience in healthcare analytics preferred.

License(s)/Certification(s):

  • HFMA, MGMA or AHIMA certification desirable

Knowledge/Skills/Abilities:

  • Strong skills including professionalism, interpersonal skills, ability to communicate effectively through written and verbal methods, process improvement skills.
  • Fluent with Epic and Microsoft office programs. Ability to manipulate large amounts of data.
  • Demonstrated decision making as it relates to processing, reconciling, and ensuring the accuracy of revenue and charge activity.
  • Knowledge of entire revenue cycle process
  • Knowledge of medical terminology and coding

Keywords: UnityPoint Health, West Des Moines , Analyst, Other , West Des Moines, Iowa

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