Revenue Cycle Analyst (Operational)

Columbia University; New York (NY); Remote; USD 90,000 - 100,000; Full time

Job summary

An established industry player is seeking a Revenue Cycle Analyst to enhance operational support in a central business office. This role involves analyzing revenue cycle operations, managing denials, and utilizing BI tools to extract and manipulate data effectively. Ideal candidates will have strong analytical abilities, advanced Excel skills, and experience in physician billing. Join a dynamic team that values collaboration and continuous improvement while making a significant impact on revenue cycle efficiency. If you're passionate about optimizing processes and driving results, this opportunity is perfect for you.

Qualifications

• 4 years of experience in physician billing and third-party payer reimbursement.
• Advanced skills in Excel and BI data applications for data manipulation.

Responsibilities

• Analyze payer correspondences to identify denials and perform data extraction.
• Develop reports and presentations for leadership on revenue cycle metrics.

Skills

Analytical Skills

Communication Skills

Problem Solving

Customer Service

Time Management

Attention to Detail

Teamwork

Adaptability

Education

Bachelor's degree

Tools

Excel

BI tools

GE/IDX

EPIC

Experian

Cognos

Tableau

Power BI

Job description

Job Type: Officer of Administration
Regular/Temporary: Regular
Hours Per Week: 35
Standard Work Schedule: 9AM-5PM, M-F
Salary Range: 90,000-100,000

The salary of the finalist selected for this role will be set based on a variety of factors, including but not limited to departmental budgets, qualifications, experience, education, licenses, specialty, and training. The above hiring range represents the University's good faith and reasonable estimate of the range of possible compensation at the time of posting.

Position Summary

Under the supervision of the Revenue Cycle Director, the Revenue Cycle Analyst is responsible for providing strong analytical assessments, reporting, and operational support on multiple aspects of revenue cycle operations in a central business office. This position will primarily support revenue cycle operations for in a central business office.

Responsibilities

Operations/Technical

• Reviews and analyzes Explanation of Benefits (EOBs), payer correspondences to identify denials to be appealed. Perform denials analysis to reduce controllable rejections.
• Perform data extraction and manipulation using BI tools, Excel, and other query tools within practice management systems.
• Utilize knowledge of group payer contracts, payer policies, payer plans, and member benefits to perform reimbursement analysis.
• Apply knowledge of professional billing, payer policies, medical coding, and key contractual terms in performing analysis. Relay changes in insurance policies discovered by claim denials to all pertinent stakeholders.
• Participate in training and other in-servicing sessions for end-user education within the central business office and service vendor.
• Facilitate and work payer projects to manage bulk appeals with various stakeholders and insurance carriers.
• Oversee various projects as directed by the Director. Operationalize project plan including developing and executing related communication plans. Track project plan progress, proactively identify areas of resistance, and outliers to escalate for mitigation, executing mitigation plans as needed. Prepare presentations for various sponsors and stakeholders as needed.
• Monitor and perform analysis on work queue inventory to identify corrective actions to work queue logic including, but not limited to, review logic criteria and ensure correct logic build, obtain feedback from work queue users to understand trends and workarounds, make recommendations to improve logic build and reduce outliers and/or backlogs.
• Develop new report templates for ad-hoc and or standard monthly reports to assist with monitoring of Revenue Cycle Metrics. Provide assessment of revenue cycle processes with a focus on process improvement and best practice. Monitor and analyze to compare with industry benchmarks.
• Prepare reports and formal presentations for leadership.
• Assist with management of user access to various systems such as payer portals, EMR, receivables system, and bank lockboxes.
• Assist management with obtaining pertinent data to support establishing and maintaining service agreements with external vendors. Facilitate auditing and processing of vendor invoices for payment.
• Assist with performance tracking of external vendor services. Assist with identifying and resolving operational issues with the deliverance of services by vendors.
• Assist unit management with a compilation of staff productivity and quality assurance statistics. Assist management by analyzing productivity and operational performance of business units through the use of key metrics and pertinent data.
• Assist Director with identifying relevant trends and opportunities. Analyze trends and key data points to maximize efficiencies with inbound and outbound collection efforts. Identify opportunities for creating estimates and pre-payment collection effort.
• Present data, analysis, and recommendations for solutions in meetings with unit management and other stakeholders.
• Effective collaborative relationships with peers and other subject matter experts (SME) to seek resolution of issues identified through monthly monitoring of KOIs/KPIs.

Strategy

• Assist unit management with a compilation of staff productivity and quality assurance statistics. Assist management by analyzing productivity and operational performance of business units through the use of key metrics and pertinent data.
• Assist the Associate Director with identifying relevant trends and opportunities. Analyze trends and key data points to maximize efficiencies within and outbound collection efforts. Identify opportunities for creating estimates and pre-payment collection effort.
• Present data, analysis, and recommendations for solutions in meetings with unit management and other stakeholders.

People

• Effective collaborative relationships with peers and other subject matter experts (SME) to seek resolution of issues identified through monthly monitoring of KOIs/KPIs.

Other

• Represent the CRO Management Team on committees, task forces, and workgroups. Negotiate workable compromise solutions to complex problems between the FPO, CRO, and other departments, outside vendors, etc.
• Conform to all applicable HIPAA, Billing Compliance, and safety policies and guidelines.
• Perform other duties and responsibilities as assigned by the Chief Revenue Cycle Office and Directors of the CRO.

Please note: While this position is primarily remote, candidates must be in a Columbia University approved telework state. There may be occasional requirements to visit the office for meetings or other business needs. Travel and accommodation costs associated with these visits will be the responsibility of the employee and will not be reimbursed by the company.

Minimum Qualifications

• Bachelor's degree or equivalent in education and experience.
• 4 years of related experience with a preference for experience in physician billing and third-party payer reimbursement.
• An equivalent combination of education and experience may be considered.
• Advanced skills in using Excel and BI data applications to maneuver through large volumes of data.
• Strong verbal and written communication skills.
• Ability to work independently and follow-through and handle multiple tasks simultaneously.
• Must be a motivated individual with a positive and exceptional work ethic.
• Proficiency in health insurance billing, collections, and eligibility as it pertains to commercial, managed care, government, and self-pay reimbursement concepts and overall operational impact.
• Strong knowledge of electronic billing systems for front end and back end functions and the willingness to learn new systems, applications, and programs.
• Advanced proficiency in data extractions (DBMS & Data Warehouse Tools) and use of business analytic applications.
• Demonstrated advanced skills in A/R management, problem assessment, and resolution, and collaborative problem-solving in complex, interdisciplinary settings. Excellent analytical skills: attention to detail, critical thinking ability, decision making, and researching skills in order to analyze a question or problem and reach a solution.
• Ability to work collaboratively with a culturally diverse staff and patient/family population, strong customer service skills, demonstrating tact and sensitivity in stressful situations.
• Must successfully pass systems training requirements.

Preferred Qualifications

• Experience with GE/IDX, EPIC, Experian, and Cognos is preferred.
• Knowledge of Epic PB Resolute is preferred.
• Familiarity with data visualization tools such as Tableau or Power BI (Power Query).

Competencies

Patient Facing Competencies	Minimum Proficiency Level
Accountability & Self-Management	Level 3 - Intermediate
Adaptability to Change & Learning Agility	Level 3 - Intermediate
Communication	Level 3 - Intermediate
Customer Service & Patient Centered	Level 3 - Intermediate
Emotional Intelligence	Level 3 - Intermediate
Problem Solving & Decision Making	Level 3 - Intermediate
Productivity & Time Management	Level 3 - Intermediate
Teamwork & Collaboration	Level 3 - Intermediate
Quality, Patient & Workplace Safety	Level 3 - Intermediate
Leadership Competencies	Minimum Proficiency Level
Business Acumen & Vision Driver	Level 2 - Basic
Performance Management	Level 1 - Introductory
Innovation & Organizational Development	Level 2 - Basic

Equal Opportunity Employer / Disability / Veteran

Columbia University is committed to the hiring of qualified local residents.