Revenue Cycle Analyst - Santa Clarita, United States - Shield Healthcare

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    Job Description

    Job Description

    Since 1957, Shield Healthcare has provided high-quality healthcare services while focusing on customer satisfaction and employee achievement.

    We are dedicated to fulfilling the medical supply needs of consumers and the caregiving community while maintaining a 99% overall customer satisfaction rating.

    Over the years, Shield HealthCare has expanded nationally with current service locations in California, Colorado, Illinois, Ohio, Texas and Washington.

    Shield HealthCare is looking for a

    Revenue Cycle Analyst

    to analyze the medical claims billing process, looking for ways to solve payer rejections and denials. Requires collaboration with cross departmental teams and strong problem solving/research skills. Assists with distributing department workflow, prioritizing projects, and achieving positive financial outcomes.

    This is an on-site position in Valencia, CA.


    JOB RESPONSIBILITIES:
    Create advanced Microsoft Excel reports/models that highlight reimbursement results and trends
    Gather and extract data from databases using AS400 queries, SQL queries, and Microsoft Power BI
    Utilize trend and comparative analyses to address revenue cycle challenges, looking for ways to solve payer rejections, denials, and underpayments
    Present quantitative and qualitative findings in a clear and concise manner
    Collaborate with staff across the organization to solve problems and improve internal efficiencies
    Establish positive relationships with third-party payers and clearinghouses to resolve billing issues
    Quantify impact of new insurance payer contracts and billing requirement changes
    Handle multiple priorities with aggressive deadlines, ensuring appropriate follow-up and closure
    Prepare variety of ad-hoc reports and analyses as requested
    Evaluate department processes for efficiency and accuracy
    Share responsibility for effectively managing accounts receivable (A/R)
    May be required to supervise a team of claims

    adjudicators/billing

    specialists, holding them accountable to achieve positive financial outcomes

    QUALIFICATIONS:
    Bachelor's Degree in Business/Finance or equivalent work experience
    3-5 years' experience in an analytical role within finance, claims management, or medical billing preferred
    Familiarity with various medical insurance payer guidelines/billing requirements is a plus
    Proven ability to communicate results of analyses to management with great impact
    Proficiency in Microsoft Office and advanced level of proficiency in Microsoft Excel
    Strong analytical, organizational, and communication skills
    Proven ability to research and solve problems

    PAY & BENEFITS:
    $35-40/hour
    Medical, Dental, and Vision
    401(k) with Company Match
    Sick and Vacation Days
    Flexible Spending Account
    Life & Disability Insurance
    Education Assistance
    Employee Referral Program


    Career-minded individuals will find our business challenging and our reputation for excellence just one of the rewards we have to offer.

    To further enhance this tradition of excellence, our employees participate in continuous training and development programs in a variety of disciplines.

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