Summary
Under the managerial oversight of Health Information Management, the Revenue Cycle Analyst -HIM serves as a primary point of contact for RCM Directors, Managers, clinical support staff, corporate compliance and other health system colleagues regarding matters that relate to the tracking and analysis of payer audits and denials. The position is responsible for assisting in the routing of pre- and post-discharge denials, outpatient denials as well as third-party payer and government audits. The analyst will coordinate and facilitate the submission of all external payer audits and appeals. Responsible for promotion of increased communication within the revenue cycle and between hospital departments in regard to the denial management and the health system audit tracking system. The position will work independently and show a strong understanding of Maine Health’s systematic, defined revenue cycle audit process per health system policy.
Required Minimum Knowledge, Skills, and Abilities (KSAs)
- Education: High School diploma or Associate's degree preferred.
- License/Certifications: N/A
- Experience: At least three to five years' experience in a healthcare setting or administrative setting
- Knowledge of medical terminology
- Demonstrate excellent organizational, computer, written and oral communication skills.
- Strong time management and critical thinking skills
- Ability to foresee projects from start to finish as well as identify trends in audit and denials management data.
- Ability to establish and maintain effective working relationships with providers, leaders, outside agency personnel, third-party payers and all levels of hospital personnel in relation to appropriate response and collaboration in the audit and denials process.
- Ability to maintain patient confidentiality in performance of duties with a working knowledge of HIPAA, CMS and MaineHealth policy and procedures surround patient privacy and compliance.
- Must be able to operate multiple integrated software applications, a strong familiarity with Microsoft Office, and electronic medical record systems.
- Displays cooperative behavior. Interacts positively and effectively with others to promote a team environment
Additional Information
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