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Revenue Cycle Analyst - Front End

Revenue Cycle Analyst - Front End

Piedmont Health Services IncChapel Hill, NC, US
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About Piedmont Health Services

Piedmont Health Services, Inc. (PHS) is a 501(c)(3) nonprofit and Federally Qualified Health Center (FQHC) in North Carolina. Dedicated to delivering top-tier, accessible, and inclusive primary healthcare, PHS has proudly served for 54 years and remains the largest community health center in central NC. Operating 10 Community Health Centers, two PACE (Program of All-Inclusive Care for the Elderly) SeniorCare facilities, and 2 Mobile Health Units, PHS extends its services to residents across five counties, including Alamance, Caswell, Chatham, Orange, and Lee.

About Piedmont Health Services

Piedmont Health Services, Inc. (PHS) is a 501(c)(3) nonprofit and Federally Qualified Health Center (FQHC) in North Carolina. Dedicated to delivering top-tier, accessible, and inclusive primary healthcare, PHS has proudly served for 54 years and remains the largest community health center in central NC. Operating 10 Community Health Centers, two PACE (Program of All-Inclusive Care for the Elderly) SeniorCare facilities, and 2 Mobile Health Units, PHS extends its services to residents across five counties, including Alamance, Caswell, Chatham, Orange, and Lee.

What's an FQHC?

Federally Qualified Health Centers (FQHC) are community-based healthcare providers that receive funds from the Health Resources and Services Administration (HRSA) Health Center Program to provide primary care services in under-served areas.

Job Title - Revenue Cycle Analyst - Front End

Department - Revenue Cycle Department

Reports to - Lead Revenue Cycle Analyst

Benefits -

  • Medical, Dental, Vision, Life Insurance (Short & Long Term Disability)
  • 403(b) Plan
  • Paid Holidays
  • CME (Continuing Medical Education)

About Position : The Revenue Cycle Analyst is responsible for performing a variety of duties related to the efficient and service-oriented revenue operations at our healthcare organization. The Front-End is responsible for managing the initial billing statuses of claims to ensure accuracy and timeliness in the claim submission process. This role includes reviewing and flagging providers for missing charges, approving and / or refiling claims, and addressing file rejects. The Back End requires the Analyst to create / analyze queries to identify and interpret revenue trends. Resolve financial discrepancies and report to Department Leadership discoverable errors and findings in a timely manner.

  • Work Location : Admin Office
  • Schedule : Monday through Friday, 8 : 00am - 5 : 00pm
  • Travel : None
  • Duties / Responsibilities -

  • Work and Analyze Front End Status of the claim's initial life cycle.
  • Retrieve charges in "New Status" with a yes indicator.
  • Visit dates greater than 72 hours, flag provider for missing charges. Status can be "New" or "In Progress".
  • Review charges that are "In Progress" status and approve orders when complete.
  • When Approved charges results in "Approved Failed" status, review error generated by system and make corrections.
  • Once claim is transmitted and results in Auto-Reject from payer, review rejection information. Make updates and refile.
  • Analyze claim denials and rejections to identify trends and root causes.
  • Collaborate with billing, coding and clinical staff to ensure accurate claim submissions.
  • Provide training and support to staff on best practices for claims management and revenue cycle processes.
  • Works in coordination with the Site Leadership to correct denied claims and assure a minimal individual error rate.
  • Offer suggestions on improving the process to make submission of clean claims to insurance.
  • Performs other duties as assigned or necessary.
  • Qualifications -

    Education : High school diploma or equivalency required

    Required

  • Must possess customer service key competencies.
  • Excellent communication, interpersonal, analytical and problem-solving skills.
  • Strong attention to detail and accuracy.
  • Ability to successfully work independently and in collaborative environments.
  • Great interpersonal skills – communicates well orally and in writing.
  • Maintains professionalism in stressful moments.
  • Preferred

  • Bilingual
  • One year of experience as an Analyst (revenue cycle, data, financial, billing, etc.) for a healthcare organization.
  • Prior work experience in the area of processing.
  • Prefer prior experience in healthcare billing
  • Current / valid License : None

    Immunizations : All PHS Required Immunizations

    Pay Range : $16.43 - $22.08

    EEO Statement

    Piedmont Health Services, Inc. provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to sex, sex stereotyping, pregnancy (including pregnancy, childbirth, and medical conditions related to pregnancy, childbirth, or breastfeeding), race, color, religion, ancestry or national origin, age, disability status, medical condition, marital status, sexual orientation, gender, gender identity, gender expression, transgender status, protected military or veteran status, citizenship status, genetic information, or any other characteristic protected by federal, state, or local laws. This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.

    Seniority level

    Seniority level

    Not Applicable

    Employment type

    Employment type

    Part-time

    Job function

    Job function

    Finance and Sales

    Industries

    Non-profit Organizations

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