Revenue Cycle Analyst – Denials & Appeals

This is a fully remote position, open to applicants in United States.

📋 Description

• Establish and nurture collaborative relationships pertaining to Revenue Cycle Management.

• Oversee revenue cycle projects and enhance operational performance related to reimbursement.

• Provide expertise and supervision for the assigned revenue cycle function.

• Examine trends, recognize opportunities, and prioritize initiatives for performance improvement.

• Ensure proper configuration of systems and workflows.

• Collaborate with departments and vendor operations teams to enhance reimbursement and cash collections.

• Monitor revenue cycle metrics and activities in relation to established goals.

• Facilitate weekly meetings addressing metrics, workflows, trends, and areas for improvement.

• Investigate and interpret changes in billing and coding, translating them into actionable departmental steps.

• Work with management on trends and issues impacting revenue cycle performance.

• Establish goals and metrics that align with the organizational strategy.

• Develop, manage, and oversee the implementation of project plans.

• Educate relevant teams on requirements and methodologies for performance improvement.

• Investigate denial trends and analyze clinical, coding, and reimbursement policies to formulate comprehensive improvement action plans.

⛳️ Requirements

• Bachelor’s Degree in business, analytics, or a healthcare-related field, or equivalent relevant experience.

• A minimum of 4-6 years of experience in medical billing and insurance collections.

• Advanced knowledge of CPT/HCPCS, ICD-10, modifier selection, and UB revenue codes.

• Proficient in medical billing systems, Microsoft Excel, medical terminology, and basic procedure coding.

• Familiarity with medical terminology and abbreviations, as well as healthcare nomenclature and systems.

• Capability to analyze, identify, and clearly articulate trends in reports.

• Ability to independently resolve complex problems using critical thinking skills.

• Skill in developing, implementing, and producing detailed analyses and reports.

• Advanced project management skills with the ability to handle multiple projects simultaneously.

• Competence in managing multiple customer demands and balancing competing priorities.

• Capacity to maintain the confidentiality of sensitive information.

🏝️ Benefits

• Comprehensive medical, dental, vision, life, and disability plans available for eligible employees and their dependents.

• Complimentary testing for employees and their immediate families.

• Fertility care benefits.

• Leave for pregnancy and baby bonding.

• 401(k) benefits.

• Commuter benefits.

• Employee referral program.