Revenue Cycle Systems Analyst

Overview

The Revenue Cycle Systems Analyst is a hybrid position that is responsible for the creation, maintenance and development of all systems, applications and processes within the Revenue Cycle arena. This is a technical position, however, roughly 40% of the job entails workflow shadowing and process improvement efforts that enhance the efficiency of the department.

• May include CDM system management and maintenance; inclusive of the ensuring the Charge Description Master (CDM) is in compliance with hospital coding procedure, departmental processes, and payer regulations; reporting directly to the Chief Revenue Officer.

Responsibilities

Data Integrity

• Serves as a SME and Trainer for super users on revenue cycle applications.

• Demonstrates the ability to troubleshoot and resolve all revenue cycle applications/tools.

• Completes all workflows, interfaces, uses and maintenance for revenue cycle applications.

• Identifies opportunities for optimization.

• Serves as a SME for the revenue cycle.Communication

• Communicates to all levels of the organization regarding application issues.

• Processes and addresses concerns/issues as it relates to technical or workflow gaps in the revenue cycle.

Project Management

• Demonstrates the ability to manage and complete assigned tasks and projects.

• Collaborates with team members to complete projects and tasks.

CDM Management

• Maintains knowledge of updates and annual maintenance by AMA standards.

• Maintains knowledge of Medicare Ambulatory Payment Classifications (APC) and the Outpatient Prospective Payment System (OPPS).

• Identifies and manages the compliance of charge capture & appropriate CPT assignment under OPPS.

• Collaborates and provides quarterly reports to clinical departmental leaders (nursing, ancillary clinical support staff, etc).

• Attends monthly meetings with the Chief Revenue Officer to review data for those departments that are on the quarterly schedule for each month.

• Responsible for the organizational CDM(s).

• Develops a pricing workflow for departments.

• Follows up with departments regarding job/project expectations and completion.

• Creates a competitive pricing process with finance following established pricing protocol.

• Responsible for the annual maintenance of the CDM.

• Responsible for the business and technology relationship with CDM technology partner(s), including an related applications.

Compliance/Safety

• Responsible for reporting any safety-related incident in a timely fashion through the Midas/RDE tool; attends all safety-related training programs; performs work in a safe manner; monitors work environment for possible safety issues and ensures others are also performing work in a safe manner.

• Stays current and complies with state and federal regulations/statutes and company policies that impact the employee's area of responsibility.

• If required for the position, ensures all certifications and/or licenses are up-to-date and valid prior to expiration dates.

• Completes all company mandatory modules and required job-specific training in the specified time frame.

• Possesses and constantly develops the knowledge and changes to HCPCS and CPT codes.

Qualifications

EducationHigh School Diploma or GED- Required

Bachelor's Degree in Computer Science or related field- Preferred

Certification & LicensuresITIL, Cisco, Cerner certifications- Preferred

ExperienceMinimum 2 years experience working in a healthcare IT capacity- Required

Experience working on projects and understanding of the sequence of events that occur prior to completion- Required

1-3 years of showcasing strong technical documentation skills- Required

1-3 years of presenting problems and recommending solutions- Required

Technical troubleshooting experience within a healthcare or clinical setting where the importance of eliminating downtimes are key- Required

Cerner experience- Preferred

Revenue Cycle experience- Preferred