RCM BA

Description

Consultant Technical Analyst - Revenue Cycle and Claims

Job Summary

• 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 viabletechnology solutions.

Responsibilities

○ Act as a quality consultant and subject matter expert, performingtesting and validation of the mapping of data elements to standards○ Collaborates with technical resources to perform root cause analysisand complete remediation of data quality issues○ Works with customers to clarify and plan for their current and futuretechnology 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, smallteams and multiple technical platforms.○ Conducts Return on Investment (ROI) and other financial analysis tosupport project funding/prioritization.○ Collaborates on driving improvement activities to achieve departmentand organizational goals.○ Coordinates with functional team to assure consistency andoptimization of overall work product○ Assumes a proactive role in driving improvement activities to achievedepartment and organizational goals to deliver value.○ Maintains current knowledge of industry and business process trendsand is able to apply that knowledge to existing business processes.○ Provides subject-matter expertise of Health Ministry processes, policiesand requirements in support of functional area process design, testingand implementation○ Identifies opportunities for process improvement and makesrecommendations 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 Healthcaresystem.○ Must have a working knowledge of relational databases/databasestructures, 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, billingand claims workflows and clinical information systems.○ Bachelor or Masters degree in related health or finance field exinformatics or bioinformatics.○ Complexity of work: Within the scope of job, requires critical thinkingskills, decisive judgment and the ability to work with minimalsupervision. Must be able to work in a stressful environment.