Technical Analyst - Revenue Cycle and Claims

Overview

Remote
Depends on Experience
Contract - W2
Contract - 12 Month(s)

Skills

Health Care
Bioinformatics
Ambulatory Care
Revenue Management
Process Improvement
Process Modeling
Informatics
Financial Analysis
Finance
Cost Accounting
Billing
Accounting
Data Modeling
SQL
Root Cause Analysis
Revenue Cycle
Claims
Mapping
Business Process

Job Details

Job Summary:
Works with stakeholders to discover, clarify, and document current and future data needs
Performs mapping of revenue cycle, clinical and claims data to a normalized data model.
Serves as a subject matter expert on the revenue cycle data domains such as Registration, Scheduling, Accounting and Billing, Cost Accounting and Claims
Builds data concepts to support Revenue Cycle and Claims use cases
Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.

Responsibilities:
Act as a quality consultant and subject matter expert, performing testing and validation of the mapping of data elements to standards
Collaborates with technical resources to perform root cause analysis and complete remediation of data quality issues
Works with customers to clarify and plan for their current and future technology needs. Determines and maps existing business processes/functions and recommends changes required to fit a tightly integrated system.
Designs and implements projects requiring systems integration, small teams and multiple technical platforms.
Conducts Return on Investment (ROI) and other financial analysis to support project funding/prioritization.
Collaborates on driving improvement activities to achieve department and organizational goals.
Coordinates with functional team to assure consistency and optimization of overall work product
Assumes a proactive role in driving improvement activities to achieve department and organizational goals to deliver value.
Maintains current knowledge of industry and business process trends and is able to apply that knowledge to existing business processes.
Provides subject-matter expertise of Health Ministry processes, policies and requirements in support of functional area process design, testing and implementation
Identifies opportunities for process improvement and makes recommendations that lead to improvements
Monitors task assignments to ensure they are performed on schedule, within intended scope and to a defined level of quality.
Escalates process and project issues that cannot be resolved

Experience:
Prior 5 years of experience working as a Revenue Cycle analyst in the Healthcare system.
Must have a working knowledge of relational databases/database structures, SQL expertise desired
Must have a strong understanding of data collected and used in EMRs, Revenue Cycle and Patient Accounting Systems.
Knowledge and experience with ambulatory and acute clinical, billing and claims workflows and clinical information systems.
Bachelor or Masters degree in related health or finance field ex informatics or bioinformatics.
Complexity of work: Within the scope of job, requires critical thinking skills, decisive judgment and the ability to work with minimal supervision.
Must be able to work in a fast paced environment.

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