Revenue Cycle Business Analyst

GENERAL OVERVIEW:

This job conducts insurance billing and follow up functions along with analysis of issues, data reporting, and support of management  with business unit needs.

ESSENTIAL RESPONSIBILITIES

• Performs extensive follow-up and collections for third parties, resolving issues that are adversely impacting claims payment. Updates data regarding changes and modifications in plan benefits and other contract information relevant to billing or claims follow up and collection processes.
• Accurately and completely produces, processes, collects, and/or posts transactions or other designated functions in a timely manner with minimal direction from management. Maintains competency, meets work standards, and maintains proficiency to perform all daily transactions and functions.
• Maintains data/reporting logs.
• Collects and maintains data for reporting. Produces professional/publishable views of data/reporting to share with internal and external customers.
• Plays a key role in maintaining data accuracy.
• Provides operational support for preparation and maintenance of reports (includes but not limited to month end close, institute reporting/support, ad hoc needs)
• Coordinates and collaborates with department supervisor, manager, and other departments regularly.
• Uses problem solving skills and planning abilities to diagnose and solve root process, payer and system issues impacting revenue cycle objectives.
• Analyzes data and processes; Identifies, quantifies and monitors account detail or workflow processes for barriers. Suggests process improvements and courses of action for problem resolution.
• Independently leads initiatives as assigned by management, coordinating task teams with department supervisor/manager or other forums to deliver results as identified and/or determined by leadership. Provides formal updates and closure.
• Conducts problem solving resolution and decision-making sessions for issues and projects.
• Promotes a culture of performance excellence by enhancing job skills through quality process improvement and tools training/certification; participating in process and operational improvement initiatives; building and maintaining effective relationships throughout organization.
• Other duties as assigned or requested.

QUALIFICATIONS:

Required

• Bachelor’s degree in related field or High School diploma/Associate's degree and at least four years of relevant subject matter experience.
• 5 years of Healthcare experience

Disclaimer: The job description has been designed to indicate the general nature and essential duties and responsibilities of work performed by employees within this job title. It may not contain a comprehensive inventory of all duties, responsibilities, and qualifications required of employees to do this job.
Compliance Requirement: This job adheres to the ethical and legal standards and behavioral expectations as set forth in the code of business conduct and company policies.

As a component of job responsibilities, employees may have access to covered information, cardholder data, or other confidential customer information that must be protected at all times.  In connection with this, all employees must comply with both the Health Insurance Portability Accountability Act of 1996 (HIPAA) as described in the Notice of Privacy Practices and Privacy Policies and Procedures as well as all data security guidelines established within the Company’s Handbook of Privacy Policies and Practices and Information Security Policy. 
Furthermore, it is every employee’s responsibility to comply with the company’s Code of Business Conduct. This includes but is not limited to adherence to applicable federal and state laws, rules, and regulations as well as company policies and training requirements.

Pay Range Minimum:

Pay Range Maximum:

Base pay is determined by a variety of factors including a candidate’s qualifications, experience, and expected contributions, as well as internal peer equity, market, and business considerations.  The displayed salary range does not reflect any geographic differential Highmark may apply for certain locations based upon comparative markets.

Highmark Health and its affiliates prohibit discrimination against qualified individuals based on their status as protected veterans or individuals with disabilities and prohibit discrimination against all individuals based on any category protected by applicable federal, state, or local law.

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