Revenue Cycle Strategy Analyst
Revenue Cycle Strategy Analyst
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Job Description
Role Summary
The Revenue Strategy Analyst will support all revenue cycle functions including Revenue Cycle Operations Payor Relations and Credentialing to support Operations and Executive Leadership. The Revenue Strategy Analyst will be responsible for gathering and aggregating data across multiple data sets to provide operations and executive leadership comprehensive insight into the financial health of the endtoend revenue cycle including fee optimization through payor mix analysis payor fee comparisons and marketdriven UCR analysis.
Duties & Responsibilities
Work with Sr. Director of Payor Relations to update marketdriven UCR analysis for annual increase recommendations create payor mix analyses and provide insights on optimizing payor mix to improve reimbursement rates and financial performance.
Work with Operations and Revenue Cycle teams to audit EOBs to ensure reimbursements are paid according to the current payor fee schedule and contractual agreements.
Create a streamlined and transparent credentialing process; support the Credentialing and Operations teams to ensure Providers are credentialed/recredential with payors and CAQH participation while monitoring the credentialing ticket system. Implement credentialing software for enterprise.
Maintain all payor contracts and support the management of payor contracts in tandem w. Sr. Payor Relations Direction. This includes renegotiation dates payor fee schedules and UCR fee schedules.
Independently design build and execute a comprehensive data model for all Payor Relations and Revenue Cycle functions; serve as the centralized gateway for all data requests with regards to Payor Relations and Revenue Cycle data.
Create and design centralized workflow functions for a hybrid team which includes offshore and onshore vendor partners.
Provide adhoc analysis including revenue trend analysis payor trend analysis revenue forecasting proformas and monitoring of specific key performance indicators.
Ability to analyze data for anomalies trends and opportunities for improvement by workflow changes or technology; able to work and manipulate copious amounts of data on multiple technology platforms and provide results in a presentable format.
Other duties as assigned.
Qualifications :
Bachelors degree Business Administration Accounting or Finance. MBA would be preferred.
57 years working in healthcare revenue cycle payor relations or related field.
Excellent Excel Power BI and Microsoft Office Suite.
Excellent problem solving and interpersonal skills.
Basic understanding of practice management software or electronica health records software.
Dental knowledge preferred.
Additional Information :
Working Environment & Physical Requirements
Working conditions include those typically seen in an office environment. Prolonged periods of sitting at a desk and working on a computer. Must be able to lift up to 15 pounds at times.
Equal Opportunity Employer
Gen4 Dental Partners provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race color religion age sex national origin disability status genetics protected veteran status sexual orientation gender identity or expression or any other characteristic protected by federal state or local laws.
Remote Work :
Yes
Employment Type :
Fulltime
Employment Type
Remote
