Senior Revenue Cycle Operations Analyst

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November 24

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HCA Healthcare

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Healthcare Insurance • Healthcare • Biotechnology

HCA Healthcare is a leading healthcare provider in the United States, dedicated to delivering high-quality medical services through a vast network of hospitals and outpatient facilities. They focus on enhancing patient care and improving health outcomes by utilizing advanced technologies and evidence-based practices. HCA Healthcare is committed to excellence and innovation in the health service sector.

10,000+ employees

⚕️ Healthcare Insurance

🧬 Biotechnology

💰 Post-IPO Debt on 2014-06

📋 Description

• Serve as a technical advisor, partnering with leadership stakeholders, on end-to-end revenue cycle management, including but not limited to registration, charge capture, coding, claims submission, denials management, and collections • Provide guidance on Epic revenue cycle functionality, workflows, and configuration best practices • Interpret payer rules, regulatory updates, and reimbursement trends, communicating relevant guidance to stakeholders • Develop and disseminate technical assistance resources, including toolkits, SOPs, and job aids tailored to stakeholder’s needs • Participate in member affiliate Customer Success meetings to offer guidance and subject matter expertise • Maintain dashboards for affiliate members to support shared accountability for front-end accuracy • Monitor and analyze revenue cycle key performance indicators (KPIs) such as days in A/R, denial rates, and collection efficiency • Offer comprehensive denials management guidance and education to leadership stakeholders aimed at minimizing the occurrence of denials. • Identify trends and performance gaps and work collaboratively with leadership stakeholders (internally and externally) to develop corrective action plans • Work with the Access Quality Manager to set revenue cycle management (RCM) priorities for Quality Analysts • Support data-driven decision-making through customized reports, dashboards, and performance plans • Facilitate peer learning and best practice sharing across CHN and the member affiliates • Conduct targeted coaching sessions and feedback loops with stakeholder leadership when new denial trends emerge • Report in a dotted line to the Senior Manager of Learning & Organizational Development to design and lead RCM training sessions and workshops including but not limited to; Epic workflows and payer compliance • Facilitate the onboarding of CHN staff engaged in all aspects of the full revenue cycle (front, mid, and back) into integrated systems and standardized processes • Educate leadership stakeholders on pulling RCM reports from Epic • Collaborate closely with internal CHN teams (Finance, Compliance, Quality, Access Operations, IT, and PCE) • Partner with Epic analysts and Better Health teams to recommend EMR enhancements that improve insurance capture accuracy and referral/authorization documentation upstream • Contribute to cross-functional initiatives to improve the overall operational effectiveness • Upholds organizational values and standards, while proactively seeking ways to improve efficiency, equity, and service excellence • Ensure compliance with all CHN and affiliate policies, as well as all state and federal regulations • Provides positive and development feedback and accountability related to all practices • Demonstrates commitment to CHN and Planned Parenthood’s health equity mission, with emphasis on racial equity and community accountability. Demonstrates dedication to learning about racial equity and addressing structural racism in healthcare • Consistently delivers high-quality results using sound judgment and data-driven decisions. Prioritizes customer needs by providing prompt, accurate service to all stakeholders • ** • ***The above duties and responsibilities are not an exhaustive list of required responsibilities, duties, and skills. Other duties may be added, and this job description can be amended at any time. **

🎯 Requirements

• 5+ years of progressively responsible experience in healthcare revenue cycle management, including billing, coding, and claims processing; • At least 2 years of experience at the management level in a relevant field. • 3-5 years of experience working in Epic • Experience providing technical assistance, training, or consultation to health centers or clinical organizations • Demonstrated proficiency in Epic revenue cycle modules (Professional Billing, Resolute, Prelude, Cadence) • Strong understanding of payer rules, CPT/HCPCS/ICD-10 coding, and reimbursement methodologies (FFS, Medicaid, managed care). • Exceptional analytical, problem-solving, and interpersonal skills. • Commitment to reproductive and sexual health access and equity. • Strong understanding of front-end access workflows (scheduling, registration, insurance verification, authorization) • Ability to translate complex payer rules into simple, repeatable scripting and workflows • Strong communication skills with both operational and technical teams • Willingness to travel in accordance with the needs of the position, as outlined in the essential functions. Compliance with all CHN travel policies, including safety guidelines while operating a personal vehicle.

🏖️ Benefits

• Health Care Coverage (Medical, Dental, & Vision); eligibility for full-time, regular employees on date of hire • Flexible Spending Accounts and Health Savings Account • Short-Term Disability and Basic Life & AD&D Insurance provided by CHN • Voluntary elections for Long Term Disability and Additional Life & AD&D Insurance available at cost • Employee Assistance Program • Retirement Plan, 3% employer match after one year of service • Paid Time Off Program includes accrual-based PTO, Health Time Off (HTO), and nine (9) paid Holidays