Operations Analyst

Job Description

Job Summary 

The Operations Analyst performs root cause identification and process improvement related to any component of the revenue cycle stream. The analyst will review and investigate errors, determine root causes and develop solutions by working with staff/departments across the enterprise. The Operations Analyst will provide strategic and tactical planning, analysis, continuous quality and productivity improvements in order to meet key performance indicators established for the organization, and effectively achieve performance goals through collaborating with internal and external stakeholders. They will be responsible for analyzing all revenue cycle operational activities, which includes charge capture, medical coding, claims management, billing, collections, customer service, denial management, cash posting, follow-up, self-pay bad debt placement, contract management and reimbursement. This person will also be involved in training staff, performing in-services and auditing staff performance. Reports to the Director of Revenue Analysis. 

Essential Functions

• Performs analysis on revenue cycle key performance indicators.
• Accomplishes business objections by identifying and solving patient and processing problems.
• Manages Denials reduction projects showing consistent improvement
• Identifies projects, defines project scope, and implement project improvements.
• Oversight of timely Industrial AR billing and collections.
• Develops problem solutions by studying system capabilities, analyzing alternative solutions, and preparing system specifications.
• Sets up and tracks new service lines and performs analysis on existing ones.
• Is knowledgeable of entity billing policy and procedures.
• Performs other duties as assigned.
• Complies with all policies and standards.

Qualifications

• Associate Degree in Business or Finance required
• Bachelor's Degree in Business or Finance preferred
• 3-5 years In hospital provider process improvement, project management, and Revenue Cycle Management required

Knowledge, Skills and Abilities

• Thorough knowledge of complex project management processes, tools, techniques and methodologies to lead multiple sites.

In-depth knowledge of healthcare billing practices, reimbursement methodologies, and regulatory requirements.

Must be a strong leader with good interpersonal relationships.

Demonstrated ability to determine the key business issues and develop appropriate action plans from multidisciplinary perspectives.

Advanced interpersonal communication skills, verbal and written.