Revenue Operations Analyst
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Job Description
Revenue Operations Analyst managing denials, appeals, claims, and AR for Cottage Health’s Pacific Diagnostic Laboratories. Improving reimbursement, collections, compliance, and laboratory revenue-cycle performance.
Responsibilities:
- Manage the day-to-day operations of denials management, appeals, self-pay inventory, claims write-offs, client edits, client portal usage, payer policy changes, AR aging across all payer classes, insurance eligibility, and insurance discovery trends
- Oversee, maintain, and communicate denials and appeals activity to clients and internal stakeholders
- Provide guidance and direction to the team to maintain or exceed goals for total AR collections, credit balances, edits and denials
- Identify emerging trends in claims payments and assess expected versus actual reimbursement
- Ensure activities comply with Cottage Health and PDL policies, procedures, and federal and state regulations
- Assist with recruitment, retention, training, and work allocation
Requirements:
- Bachelor's degree or equivalent Lab RCM work experience of 6 years
- Five years of LAB RCM experience, preferably in a multi-facility environment
- Three years of progressive responsibility in healthcare revenue cycle
- Understanding of ICD-10 coding for laboratory CPTs
- Experience working payer denials and appeal processes
- Expertise in healthcare insurance eligibility, verification, and claims filing procedures
- Expertise using software applications to maximize automation and efficiency in a business office setting
- Proficiency in Microsoft Office, especially Excel and PowerPoint
- Ability to analyze data to identify trends and process-improvement opportunities
- Experience with legal consent policies and procedures and payer contracting and policies
- Knowledge of medical terminology
- MS-Office 365 preferred
Benefits:
- Eligible employees may receive shift differentials, on-call pay, incentive pay, and bonus opportunities, where applicable
- Manager and above positions may participate in Cottage Health’s annual management incentive program
- Comprehensive Total Rewards offerings
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