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About the Role
A senior revenue cycle analyst at Madison Health is responsible for providing data analytics and system support for revenue cycle IT systems to improve functions like charge capture, billing, coding, payment posting, and denial management. The analyst will also act as a project manager, collaborating with subject matter experts to enhance business operations, productivity, revenue reconciliation, benchmarking, and reporting.
Responsibilities
- Evaluates and validates revenue data, trends, and key performance indicators to identify revenue cycle improvement opportunities.
- Uses reporting tools like Epic and Excel to provide data-driven insights.
- Acts as a subject matter expert, supporting internal team members and external stakeholders.
- Creates various reports to evaluate individual revenue cycle areas, such as accounts receivable.
- Prepares monthly reports and dashboards for monitoring of revenue cycle key performance indicators.
- Oversees the regular updates, additions, and deletions of billable items in the chargemaster.
- Ensures all CDM entries are mapped to correct CPT/HCPCS and revenue codes, adhering to third-party and CMS guidelines.
- Conducts routine audits to identify missed revenue opportunities and implement corrective measures.
- Monitors and assesses various EHR work queues and answers questions submitted by revenue cycle operations.
- Analyzes root causes for charge/claim edits, claim rejections, and insurance denials to adjust workflows and prevent future errors.
- Conducts daily, weekly, and monthly reconciliation procedures to identify posting inconsistencies and directs the information to the respective department for rectification.
- Prepares reconciliation documents for finance teams.
- Initiates proactive research and resolution of issues.
- Examines current and future state processes and provides guidance to leadership on problem-solving.
- Works with cash management to resolve challenges and adapt to industry trends and changes in payer processes.
- Ensures all workflows and data management within revenue cycle IT systems maintain patient privacy and abides by HIPAA regulation.
Requirements
- Minimum 3-5 years of experience in CDM management, health information management, or hospital revenue integrity.
- Experience with Epic electronic health record system, including report functions and add-on functions.
- Experience in healthcare billing requirements (UB-04 and 1500).
- Experience with CMS Medicare and Medicaid reimbursement methodologies.
Skills
- Data analytics
- System support
- Revenue cycle management
- Charge capture
- Billing
- Coding
- Payment posting
- Denial management
- Project management
- Reporting tools (Epic, Excel)
- Electronic health record systems
- Chargemaster management
- HIPAA regulation
Experience Level
- 3-5 years
Education Level
- Bachelor's degree in accounting, finance, health information management, computer science, informatics, or related field preferred.
Benefits
- Medical
- Dental
- Vision
- Retirement
- Paid time off
- Holidays
About the Company
- Madison Health is a community-focused healthcare organization dedicated to providing compassionate, high-quality care close to home.
- We believe our employees are the heart of our mission and are committed to fostering a supportive, collaborative workplace where every team member can thrive.