Revenue Cycle Analyst

Job Description:
Revenue Cycle Analyst:
This job description outlines a role responsible for overseeing a customer’s RCMS contract, ensuring the smooth functioning of the revenue cycle across multiple business accounts, and ensuring key performance indicators (KPIs) are met.
About the Role:
The ideal candidate should have advanced RCM knowledge, problem-solving abilities, and experience in resolving complex customer issues. They will collaborate with teams, lead billing operations, and report monthly performance.
Responsibilities:
Oversee a customer’s RCMS contract
Ensure the smooth functioning of the revenue cycle across multiple business accounts
Ensure key performance indicators (KPIs) are met
Collaborate with teams
Lead billing operations
Report monthly performance
Responsible for providing oversight of a customer’s RCMS contract
Ability to address multiple markets of business accounts
Ensure the revenue cycle is processing appropriately and KPIs are within expected parameters
Knowledge & Application
Exhibits advanced RCM knowledge
Possess wide-ranging experience using in-depth professional knowledge, acumen, concepts, and company objectives to develop and resolve complex customer business requirements
Provides solutions to issues in creative and effective ways, understanding the interrelationships of different EHR functionality and impacts
Complexity & Problem Solving: Advises on or serves as advisor on complex customer issue analysis that requires evaluation of identifiable factors
Devises solutions based on limited information and precedent and adapts existing approaches to resolve issues
Uses advanced knowledge, evaluation, judgment, and interpretation to select the right course of action
Assesses agency billing requirements, EDI files, and other RCM processes, seeks collaborative solutions, and prepares and presents recommendations
Resolves concerns with team members with minimal support from leadership to ensure a productive revenue cycle
Leads an identified effort of complex RCM billing and reporting requirements, seeks collaborative solutions, and prepares and presents recommendations
Excellent written and oral communication skills
Ability to think quickly and logically to ensure solutions are identified
Strong attention to detail and follow-through skills
Duties and Responsibilities
Maintain & coordinate billing operations and support actions with other team members
Lead efforts in payer and industry research impacting customers’ businesses
Coordinate with team members to ensure metrics are met for contracts assigned
Maintain skills of Senior Billing Specialist; step in and help team members to maintain contractual KPIs
Monitor accounts for KPI performance and escalations
Creation of month-end reporting and submission to provider practices
Assist in process development
Substantial understanding of medical billing, revenue cycle, and application of knowledge and skills to oversee customer contract(s)
Identify trends, root causes, and design solutions with minimal leadership support
Qualifications:
Bachelor’s degree and 6–8 years of medical billing experience
Excellent Excel skills
Ability to identify trends and design solutions independently
Qualifacts is an equal opportunity employer. We celebrate diversity and are committed to creating an inclusive environment for all employees.