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Revenue Cycle Operations & Compliance Analyst

Employer
CentraCare Health
Location
Willmar, Minnesota
Salary
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Industry
Technology
Role
IT
Job Type
Long-Term
Hours
Full Time

Job Details

Responsible for ensuring that all Revenue Cycle related applications are optimized and

support all functions that promote timely reimbursement and encounter resolution. Responsible for

assisting leadership with ongoing monitoring of Outstanding Accounts Receivable, DNFB, and other

performance metrics to proactively identify and capitalize upon improvement opportunities.

Responsible for coordinating, implementing, training, and supporting ongoing compliance education

and training for all Revenue Cycle staff and other departments of Carris Health.


• KEY FUNCTIONS: Primary responsibilities include:

 All Epic Resolute Hospital Billing (HB) and Professional Billing (PB) application updates, maintenance, training, reporting, optimization, and issue resolution

o Serve as inter-departmental liaison for all Billing & Collections issues o Analyze optimization of Epic HB and PB build to identify & implement efficiencies, and

perform improvement builds as necessary. o Support other Revenue Cycle Analysts in Contract Management, Claims, and

Chargemaster integration & build as necessary o Continuously train, educate, & work with various Revenue Cycle staff on optimization of

Epic application use in their daily job functions o Work directly with Epic Technical Services (TS) and partnering Health Systems for Epic

RHB utilization questions and requests as necessary, including presenting change requests to Epic Steering Committee if needed and submitting and monitoring Epic support cases.

 Maintenance, optimization, and support of all other Carris Health Revenue Cycle applications

 Build and run all necessary PFS reports as determined by Revenue Cycle Director and other Revenue Cycle managers

 Responsible for monitoring outstanding accounts receivable, DNFB, and other performance metrics continuously to proactively target and identify improvement opportunities

 Support compliance program implementation, training, and maintenance as it relates to system setup and processes


JOB RELATIONSHIPS:

A. REPORTS TO: Revenue Cycle IT & Operations Supervisor

Revised 05/2013

2

B. SUPERVISES: None

C. INTERRELATIONSHIPS WITH: Finance, Business Office, Clinical Department leadership, Physicians,

and other Clinical Staff


HOURS OF WORK: 8:00am to 4:30pm -- 5 days a week, flexible schedule


DRESS CODE: Per Department Dress Code (Office attire)


ESSENTIAL REQUIREMENTS OF WORK (Minimum qualifications necessary to function at full

productivity).

A. EDUCATION AND TRAINING: College degree preferred. Minimum of two year associates degree or equivalent experience in a Healthcare setting. Requires advanced knowledge of Rycan, Epic Systems (particularly RHB & Contract Management modules), HIM Systems, Microsoft Office applications (particularly Microsoft Excel), and other technology as assigned.

B. EXPERIENCE: Previous office experience and knowledge of Revenue Cycle, Epic applications, Contract Management, Third Party Payers, and Chargemaster management preferred. Specific experience related to medical terminology, charge documentation, coding, auditing, and Payer contracts a plus.

C. JOB KNOWLEDGE (Specific): Proficient at payment review, Hospital Electronic Health Record, and Clinical Record Information systems. Overall knowledge of business office procedures and hospital policies. General knowledge of Patient Access, HIM, Billing & Collections, Cashiering, and Data Entry functions and how they influence each other and operate within the Hospital Electronic Health Record system. Strong problem-solving, interpersonal, analytical, communication and computer skills required. Ability to effectively use and integrate all necessary software systems a must. Emphasis on confidentiality and accuracy of information. Must be a quick learner and a self starter.


BUDGET: N/A


CLIENTELE DIRECTLY AFFECTED BY JOB: Other hospitals, clinics, business office, clinical leadership,

patients, and other hospital staff.


PHYSICAL DEMANDS OF THE JOB: Minimal physical demands 1. Continuous sitting occurs while working at a work station, using a computer, and attending meetings

2. Frequent use of a telephone while holding it in the non-dominant hand and using the dominant hand for writing or using a keyboard 3. Occasional forward reaching from floor to above the shoulders - to file papers and remove them as needed 4. Approximate range is 60" from the floor

Revised 05/2013

3


PHYSICAL ENVIRONMENT OF THE JOB: Usual working conditions involving adequate light, temperature,

ample desk space, etc.


EQUIPMENT OR MACHINES USED ON THE JOB: Computers, web-based applications, internal software

applications, printer, scanner, external storage devices, telephone, calculator, copy/fax machines, and

other technology as necessary.

X
MENTAL DEMANDS OF THE JOB:

A. JUDGEMENT AND INITIATIVE:

 Knowledge of the Revenue Cycle.

 Demonstrates ability to analyze information, plan effective actions and follow through reliably to meet expectations.

 Ability to interact with all Clinical staff objectively.

 Effective oral and written communications skills.

 Functions independently and as team member.

 Able to prioritize work projects and complete them in a timely manner.

 Has knowledge of hospital systems and organizational relationships.

B. INDEPENDENT ACTION: Organizational skills needed to work and function independently with minimal supervision. Self-motivated; ability to set priorities and complete tasks on a timely basis. Ability to handle information in a confidential manner and work effectively and objectively with both Clinical and Non-Clinical staff

C. EFFECT OF ERROR: Adverse affect on the Revenue Cycle affecting performance results, cash flow, staff morale, productivity, and public relations. In addition, inaccurate data is unacceptable and must be prevented at all costs whenever possible, as it presents the possibility of inhibiting issue recognition and resolution and can negatively impact public relations, patient satisfaction, etc.

D. CONTACT WITH OTHERS: Hospital employees, department directors, Third Party Payers, patients.

X
PRINCIPAL JOB RESPONSIBILITIES, TASKS, AND AUTHORITIES:

A. RESPONSIBILITY: Revenue Cycle IT Support and Optimization PRIORITY: A % OF TIME: 65% DISCRETION: A TASKS: 1. Develop, maintain, and support all patient accounting systems, EDI software, claims

management tools, as well as other revenue cycle systems as necessary 2. Accept, respond to, and prioritize requests for modifications 3. Maintains communication to other staff who may be impacted by changes 4. Researches and identifies areas of opportunity for change.

B. RESPONSIBILITY: Develop, Administer, & Support Revenue Cycle Training Needs

PRIORITY: A % OF TIME: 20% DISCRETION: A

Revised 05/2013

4

TASKS: 1. Create, implement, and support ongoing training for all Revenue Cycle staff that

promotes process efficiency and minimizes the risk of payer denials, takebacks, and compliance issues.

2. Provides technical support and training for Revenue Cycle staff in appropriate Microsoft Office applications.

C. RESPONSIBILITY: Accounts Receivable PRIORITY: B % OF TIME: 5% DISCRETION: A TASKS:

1. Work directly with the Revenue Cycle Director, Claim Managers, and PFS Manager to ensure accounts receivable is maintained

2. Assist in supporting, analyzing, and researching accounts receivable opportunities

3. Maintain knowledge related to regulatory reviews and other communications 4. Performs other duties as assigned.

D. RESPONSIBILITY: Revenue Cycle Support PRIORITY: B % OF TIME: 5% DISCRETION: A TASKS:

1. Work directly with the Director of Revenue Cycle to ensure payer contracts are executed adequately and identify areas of improvement.

2. Assist in supporting, analyzing, and researching data for the Chargemaster 3. Maintain knowledge related to regulatory reviews and other communications 4. Performs other duties as assigned.

E. RESPONSIBILITY: Ongoing Education and Support

PRIORITY: B % OF TIME: 5% DISCRETION: A TASKS:

1. Establish and maintain proficient level of system knowledge. 2. Attend required training and complete any system wide on-line training as

assigned. 3. Ensure education of departments related to revenue cycle functions are

compliant with Medicare and other Payer requirements. 4. Provide maximum contribution to the maintenance of accounts receivable at

the goal or objective established by Carris Health. 5. Assist in development and maintenance of operational policy and procedures. 6. Adheres to Carris Health's core values, standards, policies, corporate culture,

and procedures at all entities and department levels. 7. Promotes a service orientation at all times in the performance of position duties

and responsibilities and in interactions with patients, hospital staff and visitors 8. Performs other duties as assigned.

Revised 05/2013 5

F. RESPONSIBILITY: Other Duties as Assigned

PRIORITY: C % OF TIME: DISCRETION: C Tasks: Responsible for running, analyzing and producing reports for management including but not limited to:

1. Attends monthly staff meetings. 2. Maintains good public relations 3. Answers telephone inquiries 4. Perform other duties as assigned.

G. RESPONSIBILITY: Service Excellence TASKS:

1. Demonstrate an ongoing commitment to the Service Excellence philosophy by adhering to and promoting behaviors outlined in "Standards of Excellence".

H. RESPONSIBILITY: Continuous Quality Improvement TASKS:

1. Demonstrates understanding of the CQI philosophy. 2. Participates in CQI training activities or CQI teams if appropriate. 3. Demonstrates sensitivity to customers and their needs. 4. Interacts appropriately with internal customers, i.e. coworkers within

department, staff across departments. 5 Interacts appropriately with external customers, i.e. patients, families, medical

staff, vendors. 6. Role models positive behaviors.

I. RESPONSIBILITY: Safety TASKS:

1. Maintain and promote a safe environment for all patients, visitors and staff. 2. Consistently follow all policies, practices and work rules. 3. Do not use shortcuts or work-arounds that may reduce safety or increase risk. 4. Stay alert, act responsibly and use common sense to reduce risks. 5. Report actual events and good catches as soon as possible. 6. Create a safe environment by eliminating hazards and identifying and reporting

unsafe systems. 7. Complete all mandatory safety education, attend safety sessions, review and

understand the Safety Program (available on RiceNet). Seek answers to questions you have about the Safety Program.

AUTHORITIES: The employee has the authority to complete and carry out the above tasks according to department procedure.

SPECIFIC DEMANDS OF THE JOB

Revised 05/2013 6

Never

Rarely

(1-5%)

Up to 1 hr

Occasionally (6-33%) Up to 2.5 hrs

Frequently (34-66%) 2 - 5 hrs

Continuously (67 -100%) Over 5 hrs

Company

Carris Health has 16 convenient locations in West Central and Southwest Minnesota where you can access the specialized care you need, from surgery and rehabilitation to basic wellness check-ups. Whatever you need, we've got you covered.

Company info
Website
Location
301 Becker Ave. SW.
Willmar
MN
56201
United States

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