Description:
JOB PURPOSE:
The Sr. Analyst provides oversight and support for Revenue Cycle integrity and workflow processes using data analytics. The Sr. Analyst assures all established billing, systems, and process requirements have been met in order to ensure timely and optimal reimbursement. Through the analysis of key performance indicator data, the Sr. Analyst works to improve Revenue Cycle production and efficiency. The Sr. Analyst recommends changes that will positively impact the Revenue Cycle and help Piedmont Healthcare (PHC) operate according to industry benchmarks and meet A/R performance goals and productivity. The Sr. Analyst will improve and implement internal controls over the revenue cycle and will work closely with IT on interface and system issues as required to improve the flow of data. The Sr. Analyst may lead projects for Revenue Cycle.
Qualifications:
MINIMUM EDUCATION REQUIRED:
Bachelors degree in Computer Science, Information Systems, Mathematics, Finance or a closely related field required.
In lieu of degree, six (6) years of relevant work experience will be accepted in addition to the experience requirement.
MINIMUM EXPERIENCE REQUIRED:
Three (3) years of experience exhibiting advanced performance in physician and/or hospital billing revenue cycle required.
(If no degree, a total of nine (9) years of experience required).
MINIMUM LICENSURE/CERTIFICATION REQUIRED BY LAW:
None.
ADDITIONAL QUALIFICATIONS:
Advanced knowledge of third-party insurance, and familiarity with insurance plan types; HMO, PPO, POS, and Indemnity.
Excellent knowledge of Government Programs, including Medicare (CPT, ICD coding/reimbursement, and Medicare Fraud & Abuse regulations), Medicaid and Tricare Programs.
Tableau and Epic proficiency.
Possesses thorough knowledge of HIPAA regulations.
Possesses advanced knowledge of Revenue Cycle Systems.
Healthcare experience in data analytics, systems performance, and/or accounting. Experience with root-cause analysis and lean processes.
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