Revenue Management Analyst -Patient Financial Services

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Location: Burlington, MA
Job ID: 177101-1A
Date Posted: Sep 14, 2022
Category: Professional

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Job Description

Welcome To

Welcome to Shared Services, our team uses a coordinated approach to delivering administrative and operational services across Lahey. Our Shared Services colleagues leverage resources across the organization to ensure we provide high-quality, high-value care to the communities we proudly serve.  The Shared Services team includes colleagues who focus on business and network development, legal services, facilities and real estate, human resources, information technology, finance, philanthropy and marketing and communications.

 

About the Job

Reporting to the Director of Professional Billing and Business Operations, the Revenue Management Analyst serves as the preeminent analytical resource tasked with improving revenue results and operational efficiencies throughout the professional billing revenue cycle. Due to its unique involvement across a wide scope of interdependent departments and responsibilities including but not limited to Epic and end user front to back-end billing functions and workflows, charge generation and capture, claims generation and reconciliation, remittance posting processes, retro adjudication and router actions, this position requires an advanced-level knowledge of operational policies and procedures and expertise of industry standards in an ever changing regulatory environment as well as knowledge in Epic software usage, build and performance enhancement. Performs analysis and audits on current Epic build and functionality, end user Epic workflows, payor regulatory trends compared to current Epic build with a focus on revenue cycle integrity. Due to its service focus and project management emphasis, this position requires strong interpersonal and communication skills, well-developed analytic and organizational skills. This position is a resource to administrative staff of all levels, interfacing with other departments such as Information Systems, Ambulatory Administration, and all Ambulatory Departments and Divisions. Provides quality customer service and serves as an exemplary representative of the Patient Financial Services team.

Essential Duties & Responsibilities including but not limited to:

  1. With direction and oversight of the Senior Revenue Management Analysts (SRMA), assists in analyzing, evaluating and recommending changes in support of all Epic Resolute Professional Billing, Claims, Remittance and Router applications including ongoing production maintenance, upgrades and troubleshooting.
  2. Assists the SRMA in reporting the planning, design, development, build and/or configuration of all Resolute Professional Billing applications to leadership.
  3. Uses internal and external resources to make recommendations and provide feedback to the SRMA for validation in order to guide PFS management and end-users on system requirements which includes identifying and mitigating potential impacts.
  4. Responsible for all assigned Professional Billing low priority and low impact Epic Remedy tickets to completion.
  5. With direct oversight from the SRMA, manages the ticket priority for remedy tickets submitted to PB IT. Reports priorities weekly to IT management and manages all Epic remedy ticket tracking, ticket lag and follow up.
  6. Assists the SRMA with planning, drafting, and testing prior to formal Remedy ticket submission and helps to validate all testing and build changes after completion prior to moves to Epic production.
  7. Participates and provides input in training design and development related to Epic Resolute Professional Billing and end user workflows.
  8. Assists in all Epic upgrade features with IT. Participates in the full review of upgrade opportunities, system enhancements and usage.
  9. Provides go-live support during Epic implementation, upgrades and new build enhancements.
  10. Ability to reduce manual rework and denials by performing root-cause analysis and implementing best Epic practice.
  11. Assists in the oversight and management of external system charge applications and tools.
  12. Serves as a mentor to the Professional Billing Revenue Cycle Analysts
  13. Actively participates in the Payor/Plan Committee bi-weekly meetings. Documents and submits all item requirements necessary to facilitate plan updates and/or new plan build.
  14. Assists the SRMA in the completion of billing and system projects as assigned by the Senior Manager and Department Director and identifies and reports project tasks to the Senior Manager and Department Director.
  15. Acts as a conduit between PFS leadership and IT to ensure all proposed build projects are accurately and effectively communicated and follow expected timelines.
  16. Provides constant feedback to the Senior Manager and Department Director on any issues identified during research and review.
  17. Maintains master list of PFS user records and security templates. Works with IT to add/remove security points as necessary.
  18. Evaluates the adequacy of internal controls and compliance with organizational policies and procedures.

Organizational Requirements:

  • Maintain strict adherence to the Lahey Health Confidentiality policy.
  • Incorporate Lahey Health Standards of Behavior and Guiding Principles into daily activities.
  • Comply with all Lahey Health Policies.
  • Comply with behavioral expectations of the department and Lahey Health.
  • Maintain courteous and effective interactions with colleagues and patients.
  • Demonstrate an understanding of the job description, performance expectations, and competency assessment.
  • Demonstrate a commitment toward meeting and exceeding the needs of our customers and consistently adheres to Customer Service standards.
  • Participate in departmental and/or interdepartmental quality improvement activities. 
  • Participate in and successfully completes Mandatory Education.
  • Perform all other duties as needed or directed to meet the needs of the department.

Minimum Qualifications:

Education: Bachelor Degree or Equivalent Experience Required

Licensure, Certification & Registration: Epic Revenue Cycle Certification/Proficiency: PB CDM, PB Charge Capture, PB Charge Router, claims ane remittance preferred

Experience:

 

  • 3+ years of clinical, healthcare operations, healthcare information technology experience.
  • Experience in a healthcare setting, ability to understand and document business processes, ability to multi-task and experience managing small projects with defined duration and scope.

 

About Us

Beth Israel Lahey Health is dedicated to improving health and wellness and making a difference in the lives of our patients, their families and all members of the communities we serve.  Formed in March 2019, Beth Israel Lahey Health is a patient-centered, integrated care delivery system providing a continuum of services spanning academic, tertiary and community hospitals, dedicated orthopedic and psychiatric hospitals, primary and specialty care, community acute care, ambulatory care, behavioral services and home health.  Beth Israel Lahey Health Performance Network is a unified joint contracting and population health management organization, jointly governed by participating physicians and hospitals.

Equal Opportunity Employer/Minorities/Females/Disabled/Veterans.