Job Purpose: The Revenue Cycle Management (RCM) Analyst role is responsible for managing a portfolio of client accounts to ensure that the highest levels of RCM service delivery possible are met and maintained. As part of that effort the RCM Analyst will monitor, identify, analyze, teach, our business partners and service delivery teams in proactive, efficient, and executable plans of action to ensure service delivery commitments are met and sustained.

Essential Job Responsibilities:

· Engages RCM clients directly and with internal stakeholders depending on the specific portfolio of accounts assigned and client requirements.

· Gathers data and conducts trending and analysis of performance metrics and assists with the development and execution of improvement and/or resolution plans.

· Provides suggestions to business partners and service delivery teams to drive innovative solutions and process change.

· Provides key performance analysis and/or audit feedback directly to internal business partners, and service delivery teams.

· Monitor billing, reimbursement, and collections inventories to ensure service level agreement (SLA) commitments are being met by the combined service teams. Resolves or escalates issues timely.

· Obtains, organizes, and disseminates information from the client, internal business partners, and service delivery teams to ensure all parties have the most current and required information.

· RCM Analyst will provide training and education for clients and service delivery team members on standard operating procedures, workflow directives, and/or system usage. Approximately 30% to 40% of training time would be dedicated as ongoing.

· Model the Core Values of the company (see appendix for definitions of the Core Values)

Education:

Preferred bachelor’s degree

Experience:

· Deep knowledge of Revenue Cycle Management within either Billing, Collections, or Remittance posting.

· Knowledge of insurance carriers’ payment regulations including various reimbursement schemes, coinsurance and deductibles, and contractual adjustments

· Ability to review data, identify issues, trends and propose recommendations on necessary changes to management, offshore team and/or client.

· Ability to think analytically and make effective decisions under pressure.

· Proficient in Microsoft Excel, PowerPoint, and Work.

· Clinical Lab billing experience preferred.

Preferred Qualifications / Skills:

· Knowledge of E/M, ICD-9-CM & ICD-10CM, CPT’s and HCPCS codes.

· Organized, detail-oriented, and able to multi-task in a high volume, fast-paced environment.

· Communicates professionally, clearly, and effectively in a verbal and written manner with internal and offshore team members.

· Knowledge of Telcor and Xifin if applicable.

· Minimum three (3) years’ experience in Physician or Hospital Billing, Collections, and/or Remittance