Revenue Cycle Management Analyst

Definition

Definition: Under the direction of the Revenue Cycle Manager , the Revenue Cycle Management Analyst is responsible for developing, assessing and quantifying trends and reporting related information to Revenue Cycle Department. The Revenue Cycle Management Analyst will work with staff at all levels to include Finance and Medical Networks throughout the departments of Health and Human Services. This job class is treated as FLSA Exempt.

Essential Functions: Essential functions may vary among positions and may include the following tasks, knowledge, abilities, skills and other characteristics. This list of tasks is ILLUSTRATIVE ONLY and is not intended to be a comprehensive listing of tasks performed by all positions in this classification.

Examples of Tasks

Assists RCM Manager to review, interprets and analyzes payer contract payment terms in Epic.

Accurately compute expected FQHC, FFS payments for qualifying claim-types and services billed.

Proactively monitors EPIC worklist queues, and reports on unworked lists.

Performs root cause analysis to identify underlying issues causing inefficiencies in the revenue cycle and recommend process improvements.

Assists RCM Manager to review and trend clearinghouse edits and reports follow up activity.

Review and report on EPIC KPI reports which include staff and revenue metrics

Coordinates or independently completes complex special projects.

Provides supporting documentation for RCM month end report.

Prepares ad-hoc reports as necessary and effective presentations of data processes and results by leveraging various tools such as PowerPoint, Tableau, etc.

Adheres to HIPAA compliance, privacy and confidentiality standards of HHS and the River Peoples' Health Center.

Maintains documented inventory of existing reports, clinical review, and data validation of records to identify data trends.

Performs other job-related duties as assigned to maintain and enhance departmental operation.

Knowledge, Skills, Abilities and Other Characteristics:

• Knowledge of the history, culture, laws, customs, and traditions of the Salt River Pima-Maricopa Indian Community.
• Knowledge of the technical documentation process.
• Knowledge of root cause and corrective action analysis.
• Knowledge of EHR, EMR and other related software.
• Knowledge of medical terminology and healthcare workflow processes.
• Knowledge of fundamentals statistical concepts and methodologies.
• Knowledge of performance improvement models and root cause analysis.

• Skill with verbal and written communication.
• Skill with Business Analysis.
• Skill processing data into action plans and directives to meet objectives.
• Skills presenting technical concepts to non-technical staff.
• Skill establishing and maintaining effective working relationships with co-workers at all levels.
• Skill with industry analyzing tools
• Skill in time management and organization

• Ability to communicate and work with multiple levels within the government through effective written and verbal communication.
• Ability to effectively and productively manage conflict and mediate conflict resolution
• Ability to analyze data, draw logical conclusions and make sound decisions and recommendations.
• Proficient with Microsoft office products
• Ability to conceptualize data relationships and enforce integrity rules
• Ability to work independently, take initiative and use judgment.
• Ability to meet and comply with HIPAA/Confidentiality policies and procedures and ability to handle highly confidential and sensitive patient and financial information.
• Ability to complete work assignments and special projects in a timely manner.
• Ability to understand and interpret reimbursement schedules, payment policies, patient accounting billing information and sources of data to complete analysis and financial projections.

Minimum Qualifications

Education & Experience: A Bachelor's degree from an accredited college or university in Business Administration, Finance or compatible discipline required. Master's degree preferred.

Five (5) years' experience in analytics, finance, accounting, or revenue cycle required

Experience working with Tribal 638 and FQHC strongly preferred.

Intermediate to advanced level skills in Microsoft Office Suite (Outlook, Excel, Word, Visio, and PowerPoint) using advanced Excel functions, preferred.

Equivalency: Any equivalent combination of education and/or experience that would allow the candidate to satisfactorily perform the duties of this position, will be considered.

Underfill Eligibility: An enrolled Community Member whom closely qualifies for the minimum qualifications for a position may be considered for employment under SRPMIC Policy 2-19, Underfill.

Special Requirements

• May be required to work beyond normal work hours including nights, weekends and holidays.
  

Prior to hire as an employee, applicants will be subject to drug and alcohol testing. Will be required to pass a pre-employment background/fingerprint check.

"SRPMIC is an Equal Opportunity/Affirmative Action Employer" Preference will be given to a qualified : Community Member Veteran, Community Member, Spouse of Community Member, qualified Native American, and then other qualified candidate.

In order to obtain preference, the following is required: 1) Qualified Community Member Veteran (DD-214) will be required at the time of application submission 2) Qualified Community Member (must provide Tribal I.D at time of application submission),3) Spouse of a Community Member (Marriage License/certificate and spouse Tribal ID or CIB is required at time of application submission), and 4) Native American (Tribal ID or CIB required at time of application submission).

Documents may be submitted by one of the following methods:

1) attach to application

2) fax (480) 362-5860

3) mail or hand deliver to Human Resources.

Documentation must be received by position closing date.

The IHS/BIA Form-4432 is not accepted .

Your Tribal ID/CIB must be submitted to HR-Recruitment-Two Waters.