Senior Revenue Cycle Analyst

Overview

About the Role

The primary purpose of the Senior Revenue Cycle Analyst position is to provide for the day-to-day oversight of the department’s revenue-related efforts regarding outpatient and inpatient activity. Disseminates clinical and diagnostic updates and keeps the technical and administrative staff up to date with any changes in coding or billing procedures or regulations. Produces and analyzes reports relating to the Pathology and Laboratory Medicine Charge Description Master (CDM), reconciliation of test activity with billed charges, denial of charges and other revenue-related activities. Assists and makes recommendations to the Administrative Director with regards to the financial feasibility of current or new business ventures and other efforts toward revenue enhancement. Performs billing quality assurance procedures within the Department of Pathology and Laboratory Medicine. Ensures that applicable State and Federal regulations and initiatives that revolve around the coding and billing of Medicare and Medicaid laboratory work are followed to the letter of the law. Prepares and presents training sessions for department physicians and staff members.

Responsibilities

What You’ll Do

• Performs complete random audits at least quarterly, as evidenced by submission of completed audit reports to department administrator.
• Exercises professional judgment in all areas of clinical coding and reimbursement-related issues and maintains a demeanor complementary to medical ethics.
• Responsible for overseeing the coding of all Pathology and Laboratory Medicine related procedures. Works closely with other hospital departments including Medical Records, Patient Accounts, and Patient Registration to ensure that all procedures performed are coded, posted, and billed properly.
• Provides information such as coding guidelines, proper documentation techniques, and medical terminology appropriate to the job functions as they relate to outpatient data management and revenue-related activities.
• Performs data quality reviews and audits of outpatient and inpatient encounters to validate CPT codes, CDM and modifier selection. Corrects errors and establishes processes or takes appropriate action to prevent or minimize re-occurrence of similar errors.
• Brings concerns involving compliance issues to the attention of the department director and hospital compliance office.
• Demonstrates competency in the use of computer applications used in the clinical and anatomic laboratories. Demonstrates understanding and necessary skill to investigate and resolve billing issues and coding inconsistencies. Monitors outpatient unbilled account reports for outstanding or un-coded encounters in order to reduce Accounts Receivable days for outpatients.
• Monitors the Work queue billing errors in EPIC Beaker and resolves them.
• Represents the department at revenue cycle meetings and brings identified concerns to department director for discussion and plan of resolution.
• Interacts closely with Patient Access, Patient Accounts, and Healthcare Finance Directors and Managers to ensure consistency among the technical and professional components of pathology charges.

Qualifications

What You’ll Bring

Required:

• Bachelor’s Degree in a healthcare-related field plus three (3) years of related experience required. Master’s Degree in Hospital, Public, or Business Administration preferred.
• Knowledge of CPT-4 coding, APC methodology and hospital charge master systems and processes necessary.
• Excellent oral and written communications skills and the ability to work independently on several tasks or projects simultaneously are required.
• Experience in preparation of reports and presentations required.
• Equivalent education, experience and/or training may be substituted for the degree requirements.

Credentials required: Bachelor’s Degree; MT certification or equivalent

What We Offer

• Paid Time Off (PTO)
• Medical & Prescription Drug Coverage
• Dental & Vision Insurance
• Health Savings Account (HSA) & Flexible Spending Account (FSA)
• Short- & Long-Term Disability Insurance
• Pension Plan
• Pet Insurance
• Employee Assistance Program (EAP)
• Professional Development

Compensation

The expected salary range for this position is PS-30S:  $88,646 - $107,141 - $127,834 per year, in accordance with the New Jersey Pay Transparency Law; final compensation will be commensurate with experience and qualifications.

About Us

University Hospital is one of the nation’s leading academic medical centers. As the principal teaching affiliate of Rutgers New Jersey Medical School and the only state-certified Level 1 Trauma Center in Northern New Jersey, University Hospital is training the next generation of physicians and advancing science to discovery while taking exceptional care of patients, regardless of their financial situation.

Apply Today

We encourage candidates from all backgrounds to apply. If you want to grow your career in healthcare while serving a vibrant community, we’d love to meet you.