
Business Analyst
2 weeks ago
Consultant Technical Analyst - Revenue Cycle and Claims
Job Summary:
o Works with stakeholders to discover, clarify, and document current and
future data needs
o Performs mapping of revenue cycle, clinical and claims data to a
normalized data model.
o Serves as a subject matter expert on the revenue cycle data domains
such as Registration, Scheduling, Accounting and Billing, Cost
Accounting and Claims
o Builds data concepts to support Revenue Cycle and Claims use cases
o Serves as a key resource for an assigned customer area to understand
and explain business and technical issues and to provide viable
technology solutions.
Responsibilities:
Act as a quality consultant and subject matter expert, performing
testing and validation of the mapping of data elements to standards
Collaborates with technical resources to perform root cause analysis
and complete remediation of data quality issues
Works with customers to clarify and plan for their current and future
technology needs. Determines and maps existing business
processes/functions and recommends changes required to fit a tightly
integrated system.
Designs and implements projects requiring systems integration, small
teams and multiple technical platforms.
Conducts Return on Investment (ROI) and other financial analysis to
support project funding/prioritization.
Collaborates on driving improvement activities to achieve department
and organizational goals.
Coordinates with functional team to assure consistency and
optimization of overall work product
Assumes a proactive role in driving improvement activities to achieve
department and organizational goals to deliver value.
Maintains current knowledge of industry and business process trends
and is able to apply that knowledge to existing business processes.
Provides subject-matter expertise of Health Ministry processes, policies
and requirements in support of functional area process design, testing
and implementation
Identifies opportunities for process improvement and makes
recommendations that lead to improvements
Monitors task assignments to ensure they are performed on schedule,
within intended scope and to a defined level of quality.
Escalates process and project issues that cannot be resolved
Experience:
Prior experience working as a Revenue Cycle analyst in the Healthcare
system.
Must have a working knowledge of relational databases/database
structures, SQL expertise desired
Must have a strong understanding of data collected and used in EMRs,
Revenue Cycle and Patient Accounting Systems.
Knowledge and experience with ambulatory and acute clinical, billing
and claims workflows and clinical information systems.
Bachelor or Masters degree in related health or finance field ex
informatics or bioinformatics.
Complexity of work: Within the scope of job, requires critical thinking
skills, decisive judgment and the ability to work with minimal
supervision. Must be able to work in a stressful environment.
5 years of experience preferred
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