The Senior Revenue Cycle Analyst is responsible for managing, coordinating, and implementing initiatives to improve revenue management, protection, and ensures the overall proficiency of revenue cycle processes. This position assists the revenue cycle executive leaders in working closely with administrators, physicians and other leadership to investigate and design strategic initiatives in order to improve revenue cycle statistics, reporting capabilities, and overall performance.
* Prepares and is responsible for further investigation while distributing reports on a routine basis to specific distribution groups assigned: Executive Team, Revenue Cycle Committee, and Dept. Leaders/Managers.
* Performs analysis of trends and reports out to senior leadership for findings and outcomes.
* Participates as a team member in multi-disciplinary groups to promote efficiency and effectiveness in revenue cycle operations.
* Supports leadership team of the oversight of revenue cycle daily review, data analysis, trending assessment of outsource vendor denials, and aged receivables.
* Oversees reimbursement billing procedures of third party and private insurance payers.
* Ensures compliance with Federal Government and New York Department of Health's rules, regulations, and codes including JCAHO requirements.
* Reviews reports ensuring the maintenance of statistical data and works with patient financial, credit/collections and patient access departments if needed to determine appropriate action of managing information received, i.e. error reports and bill edits.
* Identifies, communicates and coordinates best practices related to denials pre and post pay to minimize future occurrence to increase process efficiency and performance.
* Uses judgment, critical thinking and works independently to assess, identify and to communicate suggestions for change to follow required guidelines to improve efficiency and process.
* Maintains a thorough understanding of the clinical documentation, work queues, charging process and billing processes.
* Determines root causes for identified issues across all H+H hospitals or within a single hospital that impacts revenue retention.
* Provides education related to billing and improving workflow to multiple staff levels to ensure proper use of systems and optimization of system capacity.
* Collaborates with payers to facilitate resolution of process issues and implementation of changes.
* Performs other duties as assigned.
QUALIFICATIONS / REQUIREMENTS: Experience: Prior experience in a healthcare revenue cycle department with exceptional analytical reasoning skills. EPIC and Cerner Systems experience a plus. Education: Bachelor's degree preferred or equivalent in education and experience.
Licenses / Certifications: N/A
Other: If applicable, the individual performing this job may reasonably anticipate coming into contact with human blood and other potentially infectious materials. Individuals in this position are required to exercise universal precautions, use personal protective equipment and devices, and learn the policies concerning infection control.
We offer a comprehensive compensation and benefits package which includes:
401K or 403B
Flexible Saving Account
Paid Time Off
Good Samaritan Hospital
Good Samaritan Hospital in Suffern, NY, is a 286-bed hospital providing emergency, medical, surgical, obstetrical/gynecological and acute-care services to residents of Rockland and southern Orange counties in New York; and northern Bergen County, NJ. The hospital is home to a recognized cardiovascular program, comprehensive cancer-treatment services, the area's leading Wound and Hyperbaric Institute and outstanding maternal/child services that includes a Children's Diagnostic Center. Good Samaritan Hospital also provides social, psychiatric and substance-abuse services and its certified home-care agency supports residents of the Hudson Valley and beyond.
WMCHealth is a 1,900-bed healthcare system headquartered in Valhalla, New York, with ten hospitals on eight campuses spanning 6,200 square miles of the Hudson Valley. WMCHealth employs more than 12,000 people and has nearly 3,000 attending physicians. From Level 1, Level 2 and Pediatric Trauma Centers, the region’s only acute care children’s hospital, an academic medical center, several community hospitals, dozens of specialized institutes and centers, a state of the art Telemedicine program, skilled nursing, assisted living facilities, homecare services and one of the largest mental health systems in New York State, today WMCHealth is the pre-eminent provider of integrated healthcare in the Hudson Valley.