Revenue Cycle Analyst

A Revenue Cycle Analyst at at The Spine & Pain Institute of New York possesses in-depth knowledge of medical coding, particularly for the pain management specialty, laboratory, anesthesia and ambulatory surgery centers.

Essential Skills:

  • Maintains professional knowledge of regulatory and industry issues effecting medical specialty billing.
  • Understands business implications of decisions; displays orientation to profitability; demonstrates knowledge of market and competition.
  • Demonstrates excellent internal and external customer service skills.
  • Manages difficult or emotional situations; responds promptly to patient needs.
  • Must be able to communicate clearly with patients, staff, managers, and physicians both verbally and in writing.
  • Must meet deadlines and manage competing demands.
  • Functions as part of Accounts Receivable team and exhibits orientation to the larger objectives and goals of the Practice, beyond the patient accounts department.
  • Shows objectivity and openness to others’ views; gives and welcomes feedback; puts success of team above own interests.
  • Must accept feedback from others and give appropriate recognition to others.
  • Must be flexible and able to adapt to a changing environment.
  • Experience and proficiency with billing and administration functions for practice management software systems.
  • Proficiency with Microsoft Office Suite, including Word and Excel.
  • Experience with electronic medical records, patient portal, payer portal, and clearing house portal

Duties:

  • Follows policies and procedures related to billing and reimbursement activities under the direction of the manager of revenue cycle.
  • Participates with collection operations to ensure consistent application, interpretation, and implementation of policies and procedures.
  • Functions as part of an Accounts Receivable team to ensure that policies and decisions are in line with the mission and objectives of the practice and are practical and efficient within the organizational structure.
  • Analyzes and reports Accounts Receivable data monthly at a minimum and more often as needed.
  • Keeps executive management advised of trends and issues.
  • Offers suggestions for resolution.
  • Reviews, monitors, and evaluates third party reimbursement compliance and researches variances.
  • Assists with arbitration/litigation proceedings.
  • Composes and submits appeals to insurance companies.
  • Maintains appropriate internal controls over Accounts Receivable.
  • Conducts special projects and studies as directed in order to meet Practice’s financial goals.
  • Participates in staff meetings to discuss new or modified procedures within department.
  • Reviews chart documentation under audit for accuracy and completeness prior to submitting records to insurance carriers.
  • Performs provider documentation audits as needed and reports findings to manager of revenue cycle. Reviews and forwards refund requests to manager of Revenue Cycle.
  • Assists with patient complaints as needed. Assists with complicated insurance denials.
  • Maintains the strictest confidentiality in regards to patients’ accounts, in compliance with HIPAA and other privacy and security policies and regulations.
  • Maintains confidentiality in regards to internal policy implementation and/or content of confidential meeting/webinars/seminars/in-service.
  • Knowledge of credentialing process is a plus

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