Location: Minnetonka, Minnesota US
Job Number: 1029
Position Title: RCM Business Analyst
This role is responsible for oversight of A/R projects, trend identification, issue analysis and research, performing audits, issuing refund checks and running operational reports. Additionally, this role will assist the Revenue Cycle Manager with creation and maintenance of process or policy documentation and training materials. This position is responsible for creating project plans internally or externally and tracking to completion, maintaining and tracking payor changes across the market and reevaluating denials due to payor updates. The analyst will handle escalated Salesforce cases or escalated concerns from the Care Centers and RCM management team.
Essential Job Functions:
- Analyze insurance denial trends and create front end edits/rules to help increase clean claim rates and reduce denial rates.
- Create and track payer project plans associated with accounts receivable, including communication with payer representatives to initiate claims projects.
- Maintain library of process, policy, and training documents.
- Monitor and document payor updates to enhance the billing system or enhance scrubs/edits and reduce denials
- Provide weekly status reports on projects
- Communicate identified payer policy and denial trends with RCM team and other stakeholders to help increase cashflow and decrease days in accounts receivable
- Respond to Salesforce/Care Center questions and cases or escalate as needed
- Perform audits to identify opportunities to drive improvement
- Manage multiple tasks and deadlines with minimal oversight
- Participate in strategic planning sessions
- High school diploma or equivalent
- Minimum of 3 years’ experience as a biller, collector, coder, or back office support staff
- Experience in an OB/GYN setting preferred but not required
- Billing/Coding certification(s) preferred but not required
- Knowledge of payer websites, processes, local, state, and federal requirements
- Excellent written and oral communication skills
- Outstanding customer service skills
- Knowledge of Microsoft Office
- Strong organizational, problem solving and decision-making skills
- Ability to prioritize and manage multiple projects and issues effectively and simultaneously
- Self-motivated and self-starter who can work well under minimal supervision
- Strong attention to detail, research and follow up skills
- Ability to work both independently and in a team setting
- Strong working knowledge of payor denials and claims resolutions
- Able to clearly document processes and effectively communicate process to external users
Community / Marketing Title: RCM Analyst
Unified Women’s Healthcare is a company dedicated to caring for Ob-Gyn providers who care for others, be they physicians or their support staff. A team of like-minded professionals with significant business and healthcare experience, we operate with a singular mindset - great care needs great care. We take great pride in not just speaking about this, but executing on it.
As a company, our mission is to be an indispensable source of business knowledge, innovation and support to the practices in our network. We are advocates for our Ob-Gyn medical affiliates – enabling them to focus solely on the practice of medicine while we focus on the business of medicine.
We are action oriented. We strategize, implement and execute – on behalf of the practices we serve.
EEO Employer Verbiage:
We offer a competitive salary and an excellent benefit package that includes health/dental/life/STD/LTD/vision insurance, paid time off, and 401(k) plan. This company is a drug-free workplace and an Equal Employment Opportunity employer.