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Revenue Cycle Analyst Resume Samples
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Candidate Info
9
years in workforce
1
year at this job
C
Accounting And Finance
Electrical Engineering
Independent Consultant - Sr. Revenue Cycle Analyst
Provided Senior Leadership and internal consulting for a nationally recognized academic medical center with 450+ beds and annual revenues in excess of $1.3 Billion.
- Analyze process and business workflows to identify where there may be weaknesses in proposed flows and create solutions to prevent delays, backlogs, and deficiencies. Identify risks to operations and propose solutions for complex problems.
- Design processes and implement policies and procedures, necessary to achieve and sustain accurate and timely billing and collection of accounts receivables. Work in this area resulted in a net reduction of 50% (9+days) in DNFB.
- Lead the Revenue Cylce team to optimize procedural systems with other related departments (coding, contracting, information services, medical records) to accelerate the timing and amount of cash flow within the enterprise. Optimized Epic work flows for all aspects of PFS.
- Ensure all revenue cycle practices across the enterprise are compliant in all regulatory and contracted areas and that employees understand their role as it relates to compliance policies established.
Candidate Info
26
years in workforce
4
years at this job
Accounting
Revenue Cycle Analyst
- Implementation of processes and procedures from intake through collections that increased productivity and accuracy in compliance regulations with a reduction of staff.
- Excellent results in increasing cash flow, reducing days outstanding and bad debt exposure.
- Identified and corrected billing data base for compliance with Medicare and Medicaid.
- Proven 100% compliance in Medicaid billing audits for third party liability.
- Thorough knowledge and accuracy in completing month end cash reconciliation.
Candidate Info
11
years in workforce
1
year at this job
BS
Business Management
MA
Health Care Management
Senior Revenue Cycle Analyst
- Collaborate with various departments to fix system related issues in addition to payer contract discrepancies
- Identify and provide solutions to breakdowns in the revenue cycle which results in overall financial and quality improvement
- Analyze, identify trends and issues across all payers and campuses
- Identify trends in third party vendor refunds; resulting in $350,000 in department revenue for psychiatry claims as well as $1.350 million in underpaid claims for fiscal year 2016
- Maintain monthly carrier files; reporting variances in payments, follow up with payer liaisons and internal managed care departments
Candidate Info
3
years in workforce
9
months at this job
BS
Bachelor of Science
MA
Business Administration
Revenue Cycle Analyst
- Act as liaison to the Billing Manager to resolve billing issues.
- Communicate with assigned insurance carriers on all accounts past 30 days for follow-up on denials, incorrect payments, and past due accounts
- Audit medical record documentation including chart and operative reports to extract details of procedures performed and verify against daily super bills
- Responsible for reviewing and maintaining CDM
Candidate Info
10
years in workforce
6
years at this job
AS
Administrative Office Technology
Revenue Cycle Analyst
- Collecting and analyzing data from various systems using pivot table and vlookup; preparing monthly financial reports to identify unapplied cash and credits and distributed money to outstanding invoices
- Reviewing and evaluating net revenue and billing activities and ensuring contractual transactions completion
- Running monthly aging reports to identify accounts with late payment; negotiating collection and settlement or write off of debt
- Performing accounts reconciliation and journal entries clearing discrepancies and reducing aging
- Working on initiatives to improve efficiency with revenue recognition processing and reporting
Candidate Info
31
years in workforce
2
years at this job
Education
Revenue Cycle Analyst
- Identify revenue cycle obstructions and implement business process solutions for improvement
- Coordinate actives of staff responsible for charge capture, medical coding, change entry, insurance follow up and reimbursement analysis
- Responsible for operations of patient business services, insurance verification and workers compensation
- Monitor payer contracts and analyze remittances to insure obligations are met
- Negotiate on behalf of MSHS to expedite payments from all commercial payer insurance companies
Candidate Info
7
years in workforce
4
years at this job
Spanish And International Studies
Spanish
Revenue Cycle Analyst
- Provide analytic support through assessment of financial and operational metrics at institution and system levels to improve collections, reduce overhead, and maximize employee efficiency.
- Collaborate with internal and external entities for critical operation and integration needs.
- Conduct mission focused research and analysis to provide process improvement support to key decision makers within the organization.
- Prepare risk and threat assessment products, summary documents, and training material.
- Serve as primary point of contact for functional and technical customer support.
- Lead functional and technical trainings throughout organizational changes to ensure solution sustainability.
Candidate Info
4
years in workforce
1
year at this job
C
Medical Assisting
Revenue Cycle Analyst
- Daily adjudication of claims processed within the scope of the client's contracted services
- Review and process outstanding Client accounts receivable to facilitate subsequent payment and claims adjudication on a timely basis working on average 40 to 50 accounts daily
- Perform electronic and paper claim preparation and submission for various governmental and private insurance carrier
- Review payments from remittances and EOB's for accuracy; process appropriate adjustments
- Investigate and reprocess denials and partial payments
- Prepare and/or provide recommendations for initial and next level appeals for denied and/or underpaid claims
- Provide feedback that will serve to enhance the client’s revenue cycle process
Candidate Info
11
years in workforce
4
years at this job
HS
High School Diploma
Revenue Cycle Analyst I
- Assist Business Services Management team in all functions related to accounts receivable management and financial reporting by analyzing data and performing research related to all functions.
- Handle patient billing questions, complaints and inquiries with the highest degree of courtesy and professionalism.
- Offer alternative solutions and explains its financial impact.
- Communicate, reconcile, adjust and collect receivables from the customers.
- Research deferred patient inquires and legal requests for resolution.
- Serve as a liaison between Patient Account Customer Service and departmental leadership for resolution of inquires.
- Participate in Peer Interviews
- Successfully complete 40+ additional hours of online and on-sight training yearly
Candidate Info
4
years in workforce
BS
Electronics Technology
MBA
Business Administration
Revenue Cycle Analyst
- Implements process and payment for identifying under-allowed claims for multiple partner surgical facilities through AdvantX systems and other available tools.
- Verifies applicable contract by, as dictated by operational procedures: reviewing EOB messages and verifying member information for managed care plans.
- Prepares monthly performance statistics regarding appeals and recoveries. Perform analysis and corrective action plans to address root issues and communicates improvement opportunities and corrective actions based on findings.
- Monitors and tracks contractual, billing, registration, and posting errors, and provides continuous feedback to management team during monthly review meetings.
Candidate Info
11
years in workforce
2
years at this job
BS
Psychology
Revenue Cycle Analyst
- Database Administrator of the Practice Management System (GE Centricity) for the Physician's Practice Group
- Assist with Operations and Billing Functions
- Liaison between the IT department and the vendor, GE Centricity
- General Ledger reconciliation
- Assist with planning, coordinating, and documenting new applications and system upgrades
- Implement, test, and monitor electronic file transfers and interfaces
- Participate in the orientation and training of new personnel
- Medical Office Management
Candidate Info
32
years in workforce
16
years at this job
BFA
Architecture
Revenue Cycle Analyst
- Create, test, and implement custom billing/payer edits, reducing payer denials.
- Accountable for timely resolution of charge edit rule breaks.
- Responsible for design and development of training tools.
- Coordinate and facilitate training sessions.
- Assists in completing documentation for all phases of software development life cycle in accordance to Production Management Office guidelines.
- Act as a liaison between management, vendors, and SME's for resolution of system related issues.
- Provides documentation for functional design.
- Participates in internal and/or external training programs, staying current and compliant on skills applicable to assigned duties.
- Identifies and proposes opportunities for process improvement and prepares written application and/or technical specifications.
- Identifies and defines data input and output as indicated by application specifications.
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