The Sr. Analyst, Revenue Cycle at Whitney Young Health develops reporting tools needed to review and analyze revenue cycle data using multiple Electronic Health Records (EHRs), defining root causes of denials and adverse financial outcomes as it pertains to revenue cycle and patient access workflows.
- Acts as the primary resource over denial management of claims and patient access outcomes; reviews denial reporting and analyze patterns and trends of improper coding, incorrect patient registration and/or billing codes (revenue codes, cpt codes or ICD codes) and suggests solutions.
- Analyzes billing and coding to optimize reimbursement, and ensure legal compliance and accuracy in billing and medical documentation for private and government programs; identifies areas that would permit enhanced reimbursement and reduce denials of claims.
- Super user for multiple EHR’s-Athena, 10E11, Denticon, including multiple clearing house portals.
- Coordinates biweekly denial management meetings with Practice Managers to discuss denial trends, KPI performance as it relates to Patient Access registration, coding and billing and sliding fee discount program.
- Work as a liaison with HMO’s and Insurance plans.
- Verifies correct payment of claims in accordance with contracts, calling payers on open claims, sending appeals on denied claims and following up on requests for information for designated departments and special projects.
- Develops a strong working relationship with the payers to understand payer requirements, resolves problems and investigate new services.
- Play a key role in the implementation of new Electronic Medical Record.
- Collaborates with practice managers to develop and monitor procedures to ensure accurate input and collection of patient information, and to maximize individual and third party reimbursement, and identify and reduce errors
- Demonstrates excellence in both internal and external customer service.
- Understands and is able to effectively communicate HIPAA compliance, corporate compliance and client confidentiality.
- Ensures and/or remains in compliance with local, state, and federal regulation, i.e. DHHS HRSA and NYSDOH, and all accreditation standards (e.g. Joint Commission and NCQA-PCMH).
- Adheres to the National Patient Safety Goals as defined by the Joint Commission and Whitney M. Young Jr. Health Center.
- Completes other duties as assigned.
Associates Degree (3 to 5 years relevant experience may be substituted in lieu of a degree.)
3 to 5 years of report writing and analysis of revenue cycle data in a large complex healthcare setting.
Bachelor’s Degree. Strong excel experience and other report writing experience. Certification from the AAPC as a Certified Professional Claims coder.
Please be aware that as a facility regulated under Article 28 of the New York State Public Health Law, COVID-19 vaccination is a requirement of employment. Whitney Young Health also requires the COVID-19 booster.
All qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity, national origin, disability, status as a protected veteran, or any other legally protected status.