Job Title: RCM Business Analyst

Job Summary: The RCM Business Analyst will perform all data entry, reconciling and running of month end close. Manages changes in NextGen including charge master, contracting module, CPT & ICD-10 updates. Serve as RCM technical resource for projects and system interface requirements, specifications, and implementations. Responsible for developing and completing all revenue cycle management staff training on NextGen EPM and all other systems/databases used to perform billing and collections.

Positions Responsibilities:

The following are essential job accountabilities.

1. Performs end of month close, financial analysis, and reporting. Completes and distributes all department specific reports, productivity measures, clinic & RCM performance dashboards.

2. Maintain the charge master and other revenue cycle related databases to perform productivity analysis and financial reporting.

3. Maintains data integrity within RCM by performing all system edits, additions, monthly / annual maintenance. Acts as an internal consultant to RCM team and performs ad-hoc analyses along with recommendations for improvements based on data interpretation from NextGen and/or any other system database relating to revenue cycle.

4. Completes and distributes RCM and Health Center specific productivity measures and reports to support the monthly dashboards. Prepares and presents informational and educational information to RCM leadership. Collaborates with Information Technology to automate processes related to the EPM & EHR including data extraction to outside vendors and internal system automation.

5. Performs data mining and abstracting of financial information from various support tools for operating budget, planning, revenue and reimbursement analysis and other revenue related decisions as requested.

6. Various other work-related duties as assigned by supervisor. These duties and responsibilities may be added, deleted, or changed at any time at the discretion of management, formally or informally either verbally or in writing.

7. Supports the creation of department specific standard operating procedures (SOP) training tools, creates NextGen and other systems training materials, researchers and recommends technology based learning solutions to support the revenue cycle process.

8. Supports the revenue cycle process by acting as a liaison to research billing issues between the various OFH departments and RCM.

Additional Duties:

1. HIPAA compliance – Responsible for enforcing compliance with all HIPAA regulations and requirements. Treats all member information confidential.

2. Compliance – Ensure compliance with all local, state, and federal regulations.

3. QA/QI – Participate in QA/QI activities and contribute towards the overall performance improvement of the organization.

4. IT – Required to learn and use the Electronic Health Record and Practice Electronic System and its components as required by the job functions and highlighted in the Policies and Procedures.

5. All employees will participate in Patient Centered Home Health Model at Omni Family Health.

Job Requirements

1. Ability to work under pressure and handle multiple functions.

2. Knowledge of community based organizations.

3. Ability to communicate with the providers and medical/dental providers and staff.

4. Knowledge of CDT, CPT and ICD10 codes.

5. Promotes and believes in OMNI mission statement.

6. Ability to work proficiently and effectively within a timely manner.

7. Knowledge of account receivable processes, payer codes, and other bookkeeping functions.

8. Basic knowledge of ICD-A/CPT codes.

9. Knowledge of dental terminology and billing practices.

10. Ability to operate computers, Microsoft operating system and provide direction to staff as needed.

11. Must be able to take responsibility and work under pressure.

Qualifications, Education, and Experience

Education:

High school graduate or equivalent required.

Experience:

Five (5) years of revenue cycle management experience.

Responsible To: Director, Revenue Cycle Management

Classification: Full Time Position