The Revenue Cycle Analyst serves as a liaison between organizational leadership, end-users, project team members, Revenue Cycle and other internal or external resources with the objective to achieve operational efficiency, compliance and legitimate reimbursement. This role makes recommendations on structural requirements, charge mechanisms and reimbursement implications for billing within the EPIC EHR system. The Revenue Cycle Analyst also evaluates users interacting with the EHR system and associated softwares to identify education or system enhancement opportunities that support operational excellence and efficiency. This role performs application analysis concepts, including evaluation of current state against desired future state with consideration to policy, compliance, evidence, quality, operational standardization and workflow implications to monitor for, identify and prevent revenue leakage.
Perform in-depth analysis of workflows, data collection, report details, and other technical issues associated with Epic systems and applicable softwares
Understand and communicate processes for accurate, compliant charge capture, coding and documentation to support billing
Work with trainers to develop and maintain application specific training curriculum and materials
Conducts service line quality reviews leveraging reporting tools by evaluating process, functional and/or revenue gaps to determine resolution
Executes corrective projects based on analysis findings with measurable financial and/or compliance goals
Trains, monitors and supports charge capture reconciliation processes
Provide continuous quality control and process improvement through work queue monitoring, variance checks, analysis, troubleshooting and detailed research
Work in collaboration with clinical areas, EHR, IT, informatics, compliance, legal, contracting, revenue cycle and business partners to ensure revenue integrity
Organizes, analyzes and presents data for the purpose of supporting clinical leadership, and other stakeholders throughout the organization to outline and institute strategies for improvement
Supports regular updates of CPT/HCPCS and regulatory changes which includes identifying codes that have been deleted, added, or replaced and ensuring the appropriate system changes are made, supporting education is provided, and proper communication is provided to all impacted stakeholders
Participates in design, implementation and testing to ensure system function is working as expected, efficiency is optimal and business needs are met
Other duties as assigned
Skills, Abilities and Organization Expectations:
Consistently demonstrates the ability embrace and model M Health Fairview commitments
Excellent time management and organizational skills with demonstrated ability to balance multiple priorities
Ability to create strong collaborative partnerships and influence others across teams, groups and business boundaries to achieve real world problem solving
Demonstrated ability to translate user requirements into system specifications
Strong analytical and critical thinking skills
Extensive knowledge of ICD-10-CM, CPT/HCPCs procedure coding
Initiate judgment, make decisions and work autonomously under a minimal amount of supervision, to balance multiple tasks, be detail oriented, set priorities and complete assignments in a timely manner
Knowledge of government and commercial payer requirements for accurate and compliant healthcare charging and billing
Ability to access and interpret regulatory publications
Knowledge and understanding of hospital revenue cycle operations (registration, charge capture, health information management, claims, payment posting)
Ability to present to small and large groups
Consistent demonstration of excellent written and verbal communication skills
Proficiency in Microsoft Office: Word, Excel, Power-Point, Visio, Teams, SharePoint and Outlook.
Bachelors Degree in Business Administration, Health Care Administration or related area PLUS 2 years of experience in health care reimbursement, financial management or coding OR an approved equivalent combination of education and experience
2 years of applicable business-related experience
Epic Resolute Certification(s) in one or more of the following Epic applications: Resolute Professional Billing, Resolute Hospital Billing, Claims, CDM OR ability to obtain certification within one year of hire
Bachelors Degree in Business Administration, Health Care Administration or related area
3 years experience in directly related functional area of work
Together with the University of Minnesota and University of Minnesota Physicians we have created M Health Fairview. M Health Fairview is the newly expanded collaboration among the University of Minnesota, University of Minnesota Physicians, and Fairview Health Services. The healthcare system combines the best of academic and community medicine — expanding access to world-class, breakthrough care through our 10 hospitals and 60 clinics.
Fairview Health Services (fairview.org) is an award-winning, nonprofit health system providing exceptional care across the full spectrum of health care services. Fairview is one of the most comprehensive and geographically accessible systems in the state, with 10 hospitals—including an academic medical center and long-term care hospital—serving the greater Twin Cities metro area.
Its broad continuum also includes 60 primary care clinics, specialty clinics, senior living communities, retail and specialty pharmacies, pharmacy benefit management services, rehabilitation centers, counseling and home health care services, medical transportation, an integrated provider network and health insurer PreferredOne. In partnership ...with the University of Minnesota, Fairview’s 32,000 employees and 2,400 affiliated providers embrace innovation to drive a healthier future through healing, discovery and education.