About this role
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.