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This Contract to permanent position is integral to maintaining compliance and enhancing revenue capture processes within our healthcare organization. The ideal candidate will bring expertise in revenue cycle operations, billing, and claims analysis to ensure financial accuracy and operational efficiency.
Job Responsibility:
Analyze revenue cycle processes, including charge capture, coding, billing, and reimbursement, to identify areas for improvement and potential revenue leakage
Ensure compliance with payer contracts, reimbursement policies, and regulatory requirements by interpreting and applying relevant guidelines
Collaborate with clinical, operational, and IT teams to educate stakeholders, address process gaps, and implement corrective measures that enhance revenue integrity
Conduct audits of claims, accounts receivable, and denials to identify patterns and recommend solutions for discrepancies such as underpayments or overpayments
Develop and present detailed reports and dashboards to highlight key findings, trends, and actionable recommendations for senior leadership
Participate in system upgrades, process improvement efforts, and the implementation of new services to optimize charge and revenue capture
Stay informed about changes in healthcare compliance standards, payer regulations, and hospital billing requirements to maintain up-to-date practices
Requirements:
Bachelor's degree in business, finance, health information management, or a related field is preferred
Proven experience in hospital revenue cycle processes, billing, coding, or claims analysis is highly desirable
Strong analytical abilities to interpret complex billing and reimbursement data effectively
Comprehensive knowledge of healthcare compliance, payer regulations, and revenue cycle operations
Exceptional communication and collaboration skills to work effectively with diverse teams, including clinical, financial, and IT departments
Advanced proficiency in Microsoft Excel and familiarity with data analytics tools and revenue cycle systems such as Epic, Cerner, or Meditech
Expertise in healthcare revenue cycle concepts, including medical billing and claims processes, is essential
What we offer:
medical, vision, dental, and life and disability insurance