Revenue Cycle Analyst I

Job Description

The Revenue Cycle Analyst I will work internally across all Revenue Cycle functions to audit and analyze workflows and processes to maintain integrity of established best practices.

Essential Job Functions :

• Perform internal audits of Revenue Cycle processes and staff. Providing feedback to appropriate leadership.
• Assist with external payor audits. Monitor performance, communicate with payor representatives and internal departments for rapid correction of findings.
• Resolving denials through escalation and appeals.
• Resolve contract underpayments.
• Assess accounts for placement with DMHC or other state insurance board as needed.
• Review out of network reimbursement for post discharge settlements and underpayment appeals.
• Resolve escalated accounts from Business Office.
• Work with contracting department to review and resolve systemic payor issues.
• Review Revenue Cycle metrics. Implementing and monitoring improvement plans with applicable departments as needed.
• Provides analysis of all A / R to identify payer trends and patterns.
• Assist in identifying areas of opportunity to ensure achievement of established financial and operational objectives. Communicate and escalate urgent findings to Director.
• Assist with EHR / Revenue Cycle management software evaluation, selection, and implementation.

Core Competencies :

• Ability to communicate in a clear, articulate, and professional manner;
• Ability to prioritize work activities, use time efficiently and work through projects in a self-motivated manner;
• Strong research and auditing skills;
• Ability to analyze financial information and determine impact on the organization;
• Ability to identify and resolve issues in a timely and proactive manner;
• Knowledge of federal and state regulations;
• Knowledge of major commercial payers;
• Ability to review, interpret and implement managed care contracts with third-party payers;
• Denials Management, including reporting, accountability and resolution;
• Proven record of identifying process improvement opportunities and the ability to think critically about workflows;
• Demonstrated proficiency with Microsoft products, spreadsheets, databases, and project management is required.

Qualifications

• Bachelor’s in Business, Finance, Accounting, Health Management or related field
• At least five years of experience in billing or Revenue Cycle operations preferred
• Minimum of two years of substance abuse treatment experience required
• EHR and / or billing software experience required. Previous experience with CollaborateMD or Kipu a plus
• Valid Class C Driver’s License and liability insurance
• Must demonstrate the ability to write competently

Additional Information

We are proud to be an EEO employer M / F / D / V. We maintain a drug-free workplace and perform pre-employment substance abuse testing.

All qualified applicants will receive consideration for employment without regard to age, race, color, religion, sex, or national origin.

For more information about our company benefits, please visit us at discoverybehavioralhealth.com / careers /

Discovery Behavioral Health seeks to build a diverse staff that is reflective of the patients we serve and the communities where we work.

DBH encourages multiple perspectives, experiences, and strives to hire and retain a diverse workforce.