Revenue Cycle Analyst

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October 17

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ACU-Serve

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Healthcare Insurance • Fintech • SaaS

ACU-Serve is a company that specializes in optimizing revenue cycles for healthcare providers, particularly in the HME (Home Medical Equipment) and DME (Durable Medical Equipment) sectors. They focus on increasing clean claims through strategic partnerships, innovative solutions, and advanced technology. ACU-Serve's comprehensive approach includes revenue cycle management, A/R collection services, and resupply for infusion pharmacy and complex rehabilitation services, ensuring swift and accurate payments while enhancing client education and operational efficiency.

501 - 1000 employees

⚕️ Healthcare Insurance

💳 Fintech

☁️ SaaS

📋 Description

• Analyze and manage various aspects of the revenue cycle process, including billing, collections, coding, and reimbursement • Ensure accurate coding, charge capture, and billing practices in compliance with industry standards (i.e., CPT ICD-10, HIPAA) • Collect data from Clients daily or weekly to generate claims using various software platforms • Manage and monitor claims to maximize timely and accurate reimbursement, including claim submissions, denial management, and appeals • Identify opportunities to enhance revenue capture, minimize revenue errors, and reduce bad debt through analysis of key performance indicators • Analyze payer contracts, fee schedules, and reimbursement to ensure proper reimbursement is made on paid claims • Track claims that are pending due to missing or incomplete documentation (i.e.: DIF, RX, authorization, etc.) • Ensure claims are submitted promptly to insurance companies within their specified filing period • Regularly follow-up calls to insurance providers to check the status of claims not settled within 30 days or their standard processing time • Timely submission of appeals to secure correct payment for outstanding claims • Address partial payments and denials promptly while also submitting and following up on secondary claims for resolution • Deliver outstanding communication to clients both verbally and in writing • Recognize and report any issues or patterns to management as necessary • Work claims rejected in the claim’s clearinghouse and resubmit them as required • Ensure that notes are recorded within the client’s software platform in a clear, concise, and timely manner • Additional duties as assigned.

🎯 Requirements

• One year experience in revenue cycle analysis within the healthcare industry, preferably in infusion • Minimum of a high school diploma or GED is required • Post-Secondary education in a medical discipline highly desired • Knowledge of Windows, Word, and Excel is highly desired • Familiarity with healthcare IT and revenue management software • Ability to work independently and part of a team • Not required but desired experience with CPR+, Caretend, Weinfuse, HcN360 • Strong analytical skills and attention to detail • Excellent telephone and communication skills essential • Ability to use logic as a problem-solving skill, and able to recognize trends to make decisions to improve business.