Revenue Cycle Analyst
ACU-Serve
full-time
Posted on:
Location Type: Office
Location: United States
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Job Level
About the role
- Ensure accurate coding, charge capture, and billing practices in compliance with industry standards (i.e., CPT ICD-10, HIPAA)
- Collect data from our Clients daily or weekly, to generate claims using various software platforms.
- Manage and monitor claims to maximize timely and accurate reimbursement, including claim submissions, denial management and appeals.
- Identify opportunities to enhance revenue capture, minimize revenue errors, and reduce bad debt through analysis of key performance indicators.
- Analyze payer contracts, fee schedules and reimbursement to ensure proper reimbursement is made on paid claims.
- Track claims that are pending due to missing or incomplete documentation (i.e.: DIF, RX, authorization, etc.).
- Ensure claims are submitted promptly to insurance companies within their specified filing period.
- Regularly make follow-up calls to insurance providers to check the status of claims not settled within 30 days or their standard processing time.
- Timely submission of appeals to secure correct payment for outstanding claims.
- Address partial payments and denials promptly while also submitting and following up on secondary claims for resolution.
- Deliver outstanding communication to clients both verbally and in writing.
- Recognize and report any issues or patterns to management as necessary.
- Work claims rejected in the claim’s clearinghouse and resubmit them as required.
- Ensure that notes are recorded within the client’s software platform in a clear, concise, and timely manner.
- Additional duties as assigned.
Requirements
- Desired one Year experience in revenue cycle analysis within the healthcare industry, preferably in infusion.
- Minimum of a high school diploma or GED is required.
- Post-Secondary education in a medical discipline highly desired.
Benefits
- Knowledge of Windows, Word, and Excel is highly desired.
- Excellent telephone and communication skills essential.
- Strong analytical skills and attention to detail.
- Familiarity with healthcare IT and revenue management software.
- Ability to work independently and as part of a team.
- Not required but desired experience with CPR+, Caretend, Weinfuse, HcN360.
- The ability to use logic as a problem-solving skill, and able to recognize trends to make decisions to improve business.
Applicant Tracking System Keywords
Tip: use these terms in your resume and cover letter to boost ATS matches.
Hard Skills & Tools
codingcharge capturebilling practicesclaims managementdenial managementrevenue analysispayer contract analysisfee schedule analysisclaims submissionappeals processing
Soft Skills
communicationanalytical skillsproblem-solvingattention to detailorganizational skillsclient interactionfollow-upreportingtime managementteam collaboration
Certifications
high school diplomaGEDpost-secondary education in medical discipline