Revenue Cycle Analyst, Full Time

Job Description
Job Description
The Revenue Cycle Analyst is responsible and accountable for providing Quality / No Harm, Customer Experience, and Stewardship by ensuring the financial integrity of Health First,Inc/HF Medical Management by performing established financial processes that enable and expedite the billing and collections. This includes: Customer Service, billing claims according to Federal/State, and Managed Care rules, regulations and compliance guidelines, patient account research and resolution, insurance verification and benefits determination, identification of reimbursement issues, resolution of credits and issuance of refunds, identification of payment variance invoices, follow up and resolution of denied claims.
Primary Accountabilities

• Performs QA reviews related to job functions per team, ie billing, customer service, AR follow-up, collections, reimbursement trends, timely filing, etc.
• Reviews, verifies, edits and troubleshoots complex claims prior to transmission.
• Apply coding conventions in order to resolve claim issues and discrepancies with medical necessity.
• Provides financial assistance to our patients such as: payment arrangements, Medicaid eligibility, and indigent programs.
• Liaison with Legal Counsel, which includes, but not limited to: liens, asset checks, and settlements.
• Facilitates daily work flow for Pt Reimbursement Analysts I & II.
• Performs complex verification of insurance, edits and troubleshoots claim information prior to submission / transmission of claim.
• Analyzes, resolves, communicates, complex payer issues.
• Negotiates self-pay discounts according to departmental policy and procedures. Analyzes Self Pay ATB and verifies account selection prior to Bad Debt.
• Performs contractual adjustments and write-offs, with write off approval authority according to departmental policy and procedures.

Qualifications:
Qualifications

• High School Diploma required, Bachelors Degree in related field preferred.
• Three - Five years progressive experience in Healthcare Billing and AR Follow-up, or related field required.
• Excellent verbal, written communication and, problem solving skills required.
• Advanced knowledge of medical terminology, coding (ICD-9, CPT and HCPCS), State and Federal programs, managed care contracts, and accounting principals.
• Computer experience required. Proficient in standard Microsoft Windows applications.