What are the responsibilities and job description for the Revenue Cycle Senior Analyst position at Inside Higher Ed?
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Department:Health System Shared Services | Patient Accounting
Scope of Position
The Revenue Cycle Process Improvement Systems Analyst serves as an internal consultant supporting and driving implementation of the revenue cycle improvement initiative using a structured industry approved approach. This position is supportive of all revenue cycle process improvement strategic initiatives.
Position Summary
The Revenue Cycle Process Improvement Systems Analyst is also responsible for a wide variety of functions that primarily revolve around analyzing and resolving issues with accounts that involve authorization, billing, and compliance. This position serves as an expert in understanding the payers’ requirements and works with various other departments to identify issues and resolve them prior to billing or after a denial is received. This position is responsible for providing a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials. This position analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials.
The Revenue Cycle Process Improvement Systems Analyst is also responsible for a wide variety of functions that primarily revolve around analyzing and resolving issues with accounts that involve authorization, billing, and compliance. This position serves as an expert in understanding the payers’ requirements and works with various other departments to identify issues and resolve them prior to billing or after a denial is received. This position is responsible for providing a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials. This position analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials.
This position uses expert knowledge of payer authorization requirements to write and submit appeals for administrative authorization denials. Identifies and develops appropriate tools to track issues, analyzes workflows, identifies logistical and operational issues to target for improvement. Further, this position is responsible for reviewing accounts with various claim errors that require a second higher-level/comprehensive review. This can include claims with admission or discharge date discrepancies, admission order timing issues, or various other regulatory compliance issues. This position is also responsible for interdepartmental/intradepartmental communication and process improvement throughout the revenue cycle and serve as the primary trainer for onboarding peers with less experience. This position must apply industry knowledge and a thorough understanding of all available systems where revenue cycle information is held, including Midas and EPIC modules for Cadence, ADT, Ambulatory, and Resolute.
Minimum Qualifications
For Hire: For Hire: Bachelor's Degree in Business or Health Care Administration OR equivalent combination of education and experience. Master’s degree in business or Operational Efficiency highly desired. 2-3 years of operational experience within the Revenue Cycle. Familiarity with the DMAIC process and lean tools and concepts. Lean/Six Sigma certification and/or experience highly desired. Must possess excellent analytical skills, good written and oral communication skills. Must possess knowledge of process mapping/value stream mapping tools. Proficient with computer information systems, preferably Epic, Microsoft Word, Excel, PowerPoint, and Qlik.
Additional Information
Location:East Hospital - Tower (0397)
Position Type:Regular
Scheduled Hours:40
Shift:First Shift
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.
Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.
The university is an equal opportunity employer, including veterans and disability.
Current Employees And Students
If you are currently employed or enrolled as a student at The Ohio State University, please log in to Workday to use the internal application process.
Welcome To The Ohio State University's Career Site. We Invite You To Apply To Positions Of Interest. In Order To Ensure Your Application Is Complete, You Must Complete The Following
- Ensure you have all necessary documents available when starting the application process. You can review the additional job description section on postings for documents that may be required.
- Prior to submitting your application, please review and update (if necessary) the information in your candidate profile as it will transfer to your application.
Department:Health System Shared Services | Patient Accounting
Scope of Position
The Revenue Cycle Process Improvement Systems Analyst serves as an internal consultant supporting and driving implementation of the revenue cycle improvement initiative using a structured industry approved approach. This position is supportive of all revenue cycle process improvement strategic initiatives.
Position Summary
The Revenue Cycle Process Improvement Systems Analyst is also responsible for a wide variety of functions that primarily revolve around analyzing and resolving issues with accounts that involve authorization, billing, and compliance. This position serves as an expert in understanding the payers’ requirements and works with various other departments to identify issues and resolve them prior to billing or after a denial is received. This position is responsible for providing a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials. This position analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials.
The Revenue Cycle Process Improvement Systems Analyst is also responsible for a wide variety of functions that primarily revolve around analyzing and resolving issues with accounts that involve authorization, billing, and compliance. This position serves as an expert in understanding the payers’ requirements and works with various other departments to identify issues and resolve them prior to billing or after a denial is received. This position is responsible for providing a higher-level review of all medical necessity and authorization denials to determine a root cause for the denials. This position analyzes data to identify historic trends, perform comparisons against identified standards, and assists in formulating strategic plans for appealing denials.
This position uses expert knowledge of payer authorization requirements to write and submit appeals for administrative authorization denials. Identifies and develops appropriate tools to track issues, analyzes workflows, identifies logistical and operational issues to target for improvement. Further, this position is responsible for reviewing accounts with various claim errors that require a second higher-level/comprehensive review. This can include claims with admission or discharge date discrepancies, admission order timing issues, or various other regulatory compliance issues. This position is also responsible for interdepartmental/intradepartmental communication and process improvement throughout the revenue cycle and serve as the primary trainer for onboarding peers with less experience. This position must apply industry knowledge and a thorough understanding of all available systems where revenue cycle information is held, including Midas and EPIC modules for Cadence, ADT, Ambulatory, and Resolute.
Minimum Qualifications
For Hire: For Hire: Bachelor's Degree in Business or Health Care Administration OR equivalent combination of education and experience. Master’s degree in business or Operational Efficiency highly desired. 2-3 years of operational experience within the Revenue Cycle. Familiarity with the DMAIC process and lean tools and concepts. Lean/Six Sigma certification and/or experience highly desired. Must possess excellent analytical skills, good written and oral communication skills. Must possess knowledge of process mapping/value stream mapping tools. Proficient with computer information systems, preferably Epic, Microsoft Word, Excel, PowerPoint, and Qlik.
Additional Information
Location:East Hospital - Tower (0397)
Position Type:Regular
Scheduled Hours:40
Shift:First Shift
Final candidates are subject to successful completion of a background check. A drug screen or physical may be required during the post offer process.
Thank you for your interest in positions at The Ohio State University and Wexner Medical Center. Once you have applied, the most updated information on the status of your application can be found by visiting the Candidate Home section of this site. Please view your submitted applications by logging in and reviewing your status. For answers to additional questions please review the frequently asked questions.
The university is an equal opportunity employer, including veterans and disability.