Rev Cycle Performance Analyst

Summary

RadNet is a leader in radiology services, committed to delivering quality patient care with a focus on improving healthcare experiences. The Revenue Cycle Performance Analyst will be responsible for analyzing revenue cycle performance and collaborating with management to enhance operational objectives, ultimately impacting patient care positively.

Responsibilities

• Interpret basic revenue cycle and financial data. Maintain databases and templates ensuring data integrity through monitoring and auditing outputs
• Collect and assist in the analysis of qualitative/quantitative data reports extracted from various systems
• Incorporate results of statistical and qualitative analyses utilizing Microsoft Excel, Word, Access and Power Point
• Proactively analyze data to identify and resolve potential issues that could have an adverse effect on revenue cycle performance
• Apply concepts and tools of health care economics to enhance understanding of utilization, quality and performance patterns across health care networks
• Collaborate with management staff to provide rigorous analysis in support of RadNet revenue cycle operational objectives
• Prepare reports to evaluate and interpret data to monitor performance, identify trends and determine root causes of issues and makes updates to action plans created to remedy issues
• Develop financial and statistical reporting to use in analysis, tracking and trending of revenue cycle operation activities

Skills

• Bachelor's degree in Accounting, Business, Finance, Healthcare Administration, Computer Science or an equivalent combination of education and work-related experience
• Effective at working both at a detailed data level and a strategic thinking level
• Minimum 3 years' experience with medical claim business system software
• Minimum 3 years Health insurer industry experience, with business knowledge of benefits, claim systems, and adjudication principles
• Minimum 3 years of medical and/or benefit policies, provider contract and/or employer plan designs, professional and facility claim processing, and medical terminology and industry standard code sets (CPT-4, ICD-9-CM, ICD-10, etc)
• Minimum 3 years' experience managing multiple assignments, independently determine solutions, and anticipate/prevent potential problems
• Minimum 3 years' experience in Microsoft Excel, and extensive use of data query logic
• Expertise needed in EDI transaction exposure such as 270, 271 for healthcare benefits and eligibility, 276, 277 for claims status and 278 for transmitting health care service information, 837 for submitting claims, 835 for payments, 834 for benefit enrollment, and 820 for premium payments to insurance products
• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors
• Demonstrates initiative, personal awareness, professionalism and integrity, and exercises confidentiality in all areas of performance
• Follows all local, state and federal laws concerning employment to include but not limited to: I-9, Harassment, EEOC, Civil rights and ADA
• Follows OSHA regulations, RadNet and site protocols, policies and procedures

Qualifications

Must Haves

• Bachelor's degree in Accounting, Business, Finance, Healthcare Administration, Computer Science or an equivalent combination of education and work-related experience
• Effective at working both at a detailed data level and a strategic thinking level
• Minimum 3 years' experience with medical claim business system software
• Minimum 3 years Health insurer industry experience, with business knowledge of benefits, claim systems, and adjudication principles
• Minimum 3 years of medical and/or benefit policies, provider contract and/or employer plan designs, professional and facility claim processing, and medical terminology and industry standard code sets (CPT-4, ICD-9-CM, ICD-10, etc)
• Minimum 3 years' experience managing multiple assignments, independently determine solutions, and anticipate/prevent potential problems
• Minimum 3 years' experience in Microsoft Excel, and extensive use of data query logic
• Expertise needed in EDI transaction exposure such as 270, 271 for healthcare benefits and eligibility, 276, 277 for claims status and 278 for transmitting health care service information, 837 for submitting claims, 835 for payments, 834 for benefit enrollment, and 820 for premium payments to insurance products
• Communicates, cooperates, and consistently functions professionally and harmoniously with all levels of supervision, co-workers, patients, visitors, and vendors
• Demonstrates initiative, personal awareness, professionalism and integrity, and exercises confidentiality in all areas of performance
• Follows all local, state and federal laws concerning employment to include but not limited to: I-9, Harassment, EEOC, Civil rights and ADA
• Follows OSHA regulations, RadNet and site protocols, policies and procedures