At Modernizing Medicine, we look for passionate, innovative, creative Rock Stars!

Modernizing Medicine is hiring an RCM Operations Analyst. The RCM Analyst assists our RCM Client Success team by monitoring our client financial data and performance metrics to contribute to performance improvement and client satisfaction. The RCM Analyst supports our RCM Client Success team in analyzing Charges, Payments, Encounters, A/R, and denials data for our clients to decrease the percentage of denials, improve collections on claims, and identify practice trends.In addition, the RCM Analyst is responsible for developing tools and methodologies to monitor, analyze, and forecast revenue cycle trends. Ongoing responsibilities include collaborating with data management consultants, Client Success stakeholders, and operations leadership, researching client performance trends/issues, and providing forensic insight into data requests.

The Role:

• Identify opportunities to improve revenue and collection performance through analysis of charges, claim denials, payments, accounts receivable, and escalated client metrics
• Monitor operational key performance indicators to identify the root cause of poor performing metrics and make recommendations for improvement
• SME within PM, gPM, and necessary analytic tools not limited to Qlik Sense, Salesforce, TPS, & NHXS
• Develop strategies to capture additional data for better insight into performance improvement opportunities
• Assist management in developing meaningful reports and summaries that provide support to the RCM Client Success team
• Leverage management reports identifying areas for operational improvements and efficiencies for clients throughout their RCM lifecycle
• Generate standard and custom statistical and analytical reports as requested by RCM Leadership using the Patient Accounting Systems, Microsoft Excel, SQL, and/or Qlik
• Extract datasets from PM, Qlik, and other applications as necessary
• Completion of Ad Hoc report request as assigned by management
• Conduct detailed research into data and performance changes as identified and requested
• Perform initial and final quality control assessment of reports prior to distribution
• Serve as a RCM Client Success point of contact for new report requests/modifications
• Collaborates with the technology teams and consultants on the design of internal databases and data needs
• Complete accuracy checks of existing reports
• Provide support to the Client Success and Operational teams in analyzing our clients’ data
• Facilitate internal Client Success Denial Workgroup
• Establishes complementary and collaborative relationships with appropriate stakeholders/committee members, and RCM Leadership
• Identify and develop new client reporting, trending and performance feedback with benchmarking of success indicators
• Develop and upkeep scorecard/report card for client transitions throughout Client Success lifecycle
• Other duties as assigned

Skills & Requirements:

• 3 years of experience in an analytical or accounting role preferred
• 3 years of experience in a healthcare business office or similar setting
• Bachelor’s degree from an accredited 4-year university (strongly preferred) or working knowledge in capturing, analyzing, and communicating measurement results within a healthcare environment
• Understanding of database concepts and structures
• Working experience in creating, maintaining and troubleshooting data and reports
• Analyze organizational financial and operational data and displays strong analytical and reasoning skills
• Experience working with customer support/client issue resolution management
• Demonstrate a general understanding of claims processing and ability to complete root cause analysis
• Demonstrate success in process improvement
• Practices, models, and norms collaboration with the intent to increase communication and improve team outcomes
• Certified Revenue Cycle Professional (CRCP) must be obtained within 6 months of position start date
• LEAN Six Sigma Green Belt, must be obtained within 6 months of position start date
• Working knowledge Business Intelligence reporting software (example: Crystal, Qlik) preferred
• Expertise in medical billing, front-office, physician practice management, and healthcare business processes
• Comprehensive understanding of the full revenue cycle process for claim submission, medical insurance policies, and ICD-10 and CPT coding guidelines
• Advanced excel skills such as the ability to use formulas to analyze data, tables and formatting, pivot tables/charts and conditional formatting
• Knowledge of Fee For Service, Capitation, Workers Compensation
• Excellent time management skills in order to produce timely reporting

Modernizing Medicine Benefit Highlights:

• Health Insurance, 401(k), Vacation, Employee Assistance Program, Flexible Spending Accounts
• Employee Resource Groups
• Professional development opportunities including tuition reimbursement programs and unlimited access to LinkedIn Learning
• Weekly catered breakfast and lunch, treadmill workstations, quarterly onsite massages, onsite dry cleaning, onsite car wash and many more!

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