Info Tech Rev Cycle Healthcare Analyst RCM, Full Time, Day Shift

Job Summary

The Revenue Cycle Systems Analyst is a primary role in the support of configuration, maintenance and optimization of the EHR/EMR platforms supporting Revenue Cycle operation and optimization for Summit Regional Medical Center. The Revenue Cycle Systems Analyst combines technical expertise with financial and operation knowledge to maximize revenue accuracy and compliance. This role supports the organization in all Revenue Cycle related functions, scheduling, registration, eligibility, medical necessity checking, revenue generation, billing, collection, etc. It includes support of all users, application testing and troubleshooting, addressing user issues and business/regulatory operating practices defined by the organization, or working through identification of software issues (software updates, etc.) with EMR/EHR Support organization.

Essential Functions

- Serve as a subject matter expert for revenue cycle systems and functions, including Sunrise or similar platforms.

- Analyze and troubleshoot business processes or system issues against the EMR, affecting Revenue Cycle functions and making recommendations for improvement based on discoveries from quality and function, and industry trends.

- Maintain system configurations, manage master files, and update revenue-related workflows to ensure compliance with CMS, payer policies, and internal controls.

- Utilizes specialized / system specific computer application knowledge, or resources to problem solve and implement solutions ensuring seamless Revenue Cycle integration and data integrity.

- Participate in new system implementations, upgrades, and interfacing projects, including testing, training and validation.

- Assist in identifying workflow enhancements, writing instructions manuals and implement training requirements for systems applications to increase efficiency and productivity.

- Collaborates with internal or external clients to identify analytical and workflow needs.

- Works with Department Directors, Leads and End Users to gather specifications for vendors to facilitate business objectives or pathways to increase operating efficiency or to adapt programs to meet new requirements.

- Reviews data for integrity and accuracy; audits and ensures data integrity of information entered into the information systems.

- Assists in benchmarking processes by gathering and pulling related data as needed.

- Shares knowledge and experience regarding Summit Healthcare specific applications with appropriate staff.

- Manage and prioritize outstanding support issues.

- Maintain and utilize Helpdesk Software according to department guidelines.

- Maintains and protects confidentiality in all aspects regarding patient care and employee information.

- Understands and complies with security / access Information Management policies

Other Duties

- Participates in departmental and association wide informational meetings and in-services, including staff meetings, association wide forums, and seminars.

- Attends Revenue Cycle conferences, education, and / or seminars provided by HFMA to keep abreast of industry standards.

- Reviews department and association wide policies and procedures annually. Develops and maintains new policies and procedures as needed.

- Duties, responsibilities and activities may change or new ones may be assigned at any time with or without notice.

Abilities

- This position requires operational knowledge of all equipment and software systems in the Revenue Cycle Support Services Department, including computer hardware, fax, printer, copy machine, scanner, shredder, phone systems, and commonly used hospital computer programs (including Windows Operating Systems, Microsoft Office, Adobe Acrobat, e-mail, and internet).

- Knowledge of reporting platforms, data analysis models, project management models, and financial management principles,

- Must be service oriented and have excellent computer skills, problem-solving skills, customer service skills, organizational skills, multitasking skills, professional interpersonal skills, time management skills, the ability to prioritize work, and telephone etiquette.

- Ability to read, analyze, and interpret common scientific and / or technical journals, financial reports, and legal documents.

- Ability to write reports, policies and procedure manuals, business correspondence, memos and letters that conform to accepted standards of professional business communications style and format.

- Ability to effectively present information to both top and middle management, employees, customers, public groups and / or board of trustees.

- Demonstrated ability in data extraction, complex analysis, and reporting.

- Knowledge of clinical operations and process improvement methodologies.

- Familiarity with healthcare terminology such as diagnosis code, CPT, DRG, etc.

- Demonstrated ability to leverage and manipulate spreadsheets and graphs.

- Ability to work effectively and efficiently with a degree of accuracy under tight deadlines and high volumes.

- Must read, write, speak, and understand English.

Supervisory Responsibilities

-          None

Physical Demands

Exerts up to 20 lbs. of force occasionally, and/or up to 10 lbs. of force frequently, and/or a negligible amount of force constantly to move objects. Physical demands are in excess of those of Sedentary work. Light work usually requires walking or standing to a significant degree. Worker is exposed to extensive computer work.

Preferred Education and Experience

- Bachelor’s Degree in IT, Healthcare, or health related field.

- 3 – 5 years experience in healthcare, data analytics or project management.

- Certified Revenue Cycle Representative (CRCR) certification (within one year of hire).

OSHA Exposure Category:

Involves no regular exposure to blood, body fluids, or tissues, and tasks that involve exposure to blood, body fluids, or tissues and are not a condition of employment.

This is a safety sensitive position.