Revenue Cycle Analyst - Lead - HIM in Brewer, Maine

Company: Eastern Maine Healthcare Systems


Job Details

Job Summary:

The Revenue Cycle Lead Analyst is an analytical and process improvement lead role in identifying and implementing process improvements in an effort to operate "best in class" revenue cycle Health Information Management (HIM) across all members in EMHS system without reducing quality or service.This position serves in a key role to improve the overall effectiveness of revenue cycle HIM policy, practices and technology platforms for all EMHS organizations.The primary responsibility of this role is to serve as an internal subject matter expert with strong financial health care acuity, the ability to provide accurate analysis and clearly share results to management.Strong communication skills are required.This role will analyze complex data including clinical and financial data and transform to relevant information.In addition this role will serve as a leading resource in the areas of process improvement, organizational development, change management, performance monitoring, and other analytics.

They will serve as a project facilitator, lead change analyst and will apply influential techniques to lead teams toward best practice solutions



The Revenue Cycle Lead Analyst HIM will focus on system-wide process, technology, controls and key personnel that must be coordinated to achieve revenue integrity, compliance and customer satisfaction.

These tactics may involve the need to:
gather requirements, analyze findings, design solutions, write specifications and implement new and improved processes and recommend ongoing controls and protocols as well as other broader and unique tasks. Effectiveness of this position shall be measured in terms of assisting teams to achieve financial and other tactical, high quality output, and customer service satisfaction.

It is critical that this position be highly effective in delivering the services described in the Duties and Responsibility and work harmoniously with staff across EMHS. Effectiveness will be measured in terms of results, commitment to EMHS and customer satisfaction.

This position is a member of the EMHS Revenue Cycle team. Duties may be changed or reassigned by the Chief Revenue Officer as need arises.



Job Functions and Duties:


The Revenue Cycle Lead Analyst HIM reports to the System Director of Health Information Management (HIM). The analyst is responsible for managing and coordinating operations and workflow processes of Revenue Cycle HIM areas of Coding, Clinical Documentation Improvement, Transcription, Record Completion, Release of Information, Paper Document Scanning, and Audit Support (Clinical Documentation Integrity (CDI), Third party and internal) identified across all members of EMHS. This role will collaborate with their customers to help achieve goals that are efficient, increase revenue, and minimize costs. This position will incorporate the organization's mission, vision and values into all staff development practices and all departmentally directed activities.

General

1. Research standard business practices for revenue cycle and provide education to hardwire

2. Develop tools to regularly report measurable results

3. Identify and implement process improvements in an effort to achieve Best-in-Practice Revenue Cycle

4. Analyze complex clinical and financial data and transform to data driving positive change

5. Serve as project facilitator and lead change analyst

6. Seek appropriate education and training to become knowledgeable in all areas of the position

7. Participate in work groups and committees as needed

8. Maintain memberships with HFMA or other organizations providing relevant content.

9. Perform other duties as assigned.

Technology

* Seek and recommend new information technology solutions and or manual changes that support clinical documentation, coding and revenue cycle functions.

* Work collaboratively with departmental personnel to implement systems and process change aimed at improving clinical documentation, coding and revenue cycle performance.

Training & Education

* Educate departments and operational areas regarding the impact of their department on the revenue.

* Educate departments and operational areas regarding the impact of their department on the revenue.

* Work closely with operational directors and managers to identify common areas of deficiencies and create training sessions to correct the noted deficiencies.

Professional Development

* Attend local, regional and national conferences/seminars to remain current in supporting the needs of clinical documentation and revenue cycle activities.

* Reviews Third Party Regulatory publications to maintain knowledge base concerning compliance, clinical documentation requirements, billing requirements, reimbursement and coverage issues. Will distribute notifications of all changes in billing requirement/coverage issues to the appropriate clinical department head or support staff.



* Maintains current knowledge of regulatory developments involving agencies such as (CMS, MHDO, DHS, and Joint Commissions)

Note:
the duties listed above reflect the majority of the duties of this job and does not, nor is it intended to, reflect all duties that may be required for an incumbent in this job to perform.



Education and Experience:


* Bachelor's degree preferably in a clinical discipline, with knowledge of Health Information Management. Eight years of progressive, relevant knowledge toward mastery in the field accepted in lieu of Bachelor's degree.

* At least five (5) years of progressively responsible experience in HIM/Coding, CDI, or revenue cycle operations preferred.

* At least three (3) years clinical experience, preferably as a registered nurse in a clinical setting preferred.

* Prior auditing experience preferred

* Experience with EMHS Software, data and business information is preferred.

* Working knowledge of Medical Terminology, Current Procedural Coding (CPT, HCPCS), Diagnostic Coding (ICD-9, ICD-10), and HIPAA ANSI codes.

* Working knowledge of Microsoft Office, Excel, Access, Siemen's, Monarch, Allscripts, Meditech, and other Revenue Cycle systems.



* Demonstrated experience in diagnosing, evaluating and developing corrective actions for problems

Licenses and Certifications:


* Clinical License preferred.

* HIM, Compliance or Auditing related certificates preferred, or acquired within two years.



Knowledge, Skills, and Abilities:


* Detailed knowledge of Health Information Management, Revenue Cycle, reimbursement, data streams, and auditing principles.

* Demonstrated experience in gathering, diagnosing, evaluating and developing corrective actions for problems in revenue cycle operations.

* Knowledge of business analysis techniques required.

* Working knowledge of all functional areas of the revenue cycle, including contract and denial management, CDM and charge capture management, contract terms and requirements, and strategic pricing.

* Expertise with regulations and accreditation standards, knowledge of specific state and federal requirements and standards as it relates to modern Revenue Cycle systems.

* Working knowledge of Medical Terminology, Current Procedural Coding (CPT, HCPCS), Diagnostic Coding (ICD-9, ICD-10), and HIPAA ANSI codes (remark and adjustment codes).

* Excellent communications skills, both oral and written.

* Intermediate Microsoft software knowledge and ability to train/assist end-users.

* Ability to interpret an extensive variety of instructions furnished in written, oral, diagram, or schematic form.

* Ability to effectively influence change.

* Flexible and able to react to ever changing priorities.

* Experience with EMHS Software, data and business information is preferred.



Travel Requirements:


* 15 50% travel may be required.

* Employee must have a valid drivers' license and possess own transportation.

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