rcm ba

RCM BA Analytical Services Locations:

• Hinjewadi, Pune, India
• Coimbatore, Tamil Nadu
• Chennai, India

Consultant Technical Analyst - Revenue Cycle and Claims

• Works with stakeholders to discover, clarify, and document current and future data needs.
• Performs mapping of revenue cycle, clinical and claims data to a normalized data model.
• Serves as a subject matter expert on the revenue cycle data domains such as Registration, Scheduling, Accounting and Billing, Cost Accounting, and Claims.
• Builds data concepts to support Revenue Cycle and Claims use cases.
• Serves as a key resource for an assigned customer area to understand and explain business and technical issues and to provide viable technology solutions.

• 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 the 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.

• 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 Master's degree in a related health or finance field (e.g., 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.