Operations Revenue Analyst

Job Description:
Responsibilities Under the direction of the Assistant Director and Billing Operations Manager, the MSO III serves as a front line Operations Revenue Analyst for the Department of Patient Business Services (PBS).
Duties include direct management support of PBS billing staff, which includes billers, pre-billing and billing clerical support.
The Operations Revenue Analyst must possess budget development and monitoring; review and control of salary and supply expenditures for the department; Responsible for direct management of DNFB, FB, In-House, inpatient, outpatient, outpatient surgeries, ER and recurring outpatients.
Assures that the Billing, KPI's are achieved and exceeded: Primary Billing to occur same day of receipt, Secondary COB Billing to occur w/in 2 business days, Develop and implement Implant Invoice Bill Hold NTE 1 business day, Develop and implement Pharmacy invoice Hold NTE 1 business day, Identification of Stop Loss thresholds and correct claims filing per payer regulations, Implement daily validation of EDI claims receipt, Ongoing interim billing frequency management of all payers, Ongoing analysis of hard copy billing for conversion to optimize electronic billing, Optimization of EDI edits, excel and other reports as assigned; Active EDI system implementation participation, Daily review and monitoring of EDI Claims Control Center.
Additionally, administratively manages reporting staff time and attendance, active coaching and counseling.
Must be proficient in oral and written communication.
Must possess the ability to work well independently and in a group setting.
Qualifications Two years Hospital Billing Supervisory experience in Billing.
Two year experience in billing Commercial, Work Comp, Third party, Medicare and Medical Knowledge of Rev Codes, HCPCS, Diagnosis and Procedure codes Knowledge of Admissions, Registration, UR and Care Coordination processes Epic/Care Connect experience required Cirius Billing system or other billing system required Knowledge in MS Office, excel, MS Word required Strong knowledge on using Computer, spreadsheets and other programs Good skills in review, research and documentation Ability to handle deadlines in a very busy area in a very high energy department Ability to handle sensitive and confidential issues within a culturally diverse environment.
Ability to delegate routine/normal problems, Knowledge of HR and Personnel protocols, including recruitment, performance evaluations and disciplinary actions.
Ability to conduct themselves in a professional manner at all times.
Ability to work varying schedules and weekends as deemed necessary for continual departmental operations.
Excellent communications skills, both verbal and written Demonstrated ability to apply and interpret Managed Care and Government contract terms Exceptional Customer Service

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