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For your reference, we have included the original job posting below.
Healthcare Revenue and Operations Analyst
Job Number:
37098372
Company Name:
Public Consulting Group
Job Location:
Boston, MA US
Job Category:
Management & Business
Healthcare Revenue and Operations Analyst
Healthcare Revenue and Operations Analyst Tracking Code 11-167-HHS-MA Job Description
PCG currently seeks Financial and Operational Analysts to work in our headquarters office located at 148 State Street in Boston, MA. The Financial and Operational Analyst provides ongoing support on various projects in the areas of financial and statistical reporting and analysis, support billing operations, claim rejection and denial analysis, cash reconciliation procedures and provider revenue cycle operations. Potential for some Out of State Travel to participate in pre-bid conferences, client presentations, status report meetings, on-site provider assessments. Specific Responsibilities: Billing and Collections Ensure all services rendered are properly authorized, documented, captured and billed appropriately. Help to monitor day-to-day operations by compiling data to track staff performance levels. * Process large volume of claims. * Review and monitor all billed and paid claim statistics. * Assist with reconciliation of accounts receivable and third party payers. * Participate in review and recommend changes to fees and coding practices. * Develop fee schedule by payer. * Implement new processes to address workflow problems. * Identify operational processes to increase provider revenues and lower operating costs. * Develop solutions to client problems in a timely manner in order to meet client goals and objectives. Financial Analysis * Conduct trend and comparative analysis of key financial data and performance indicators. * Prepare revenue projections and provide financial data and analysis. * Prepare monthly status reports of key indicators to a diverse set of health care clients. * Analyze reimbursement rates by service code and compare to contract allowed amounts. * Provide consultation and assistance regarding the financial and statistical data to clients. * Make recommendations for improving financial performance. Data Management and Reporting * Develop and run Microsoft Access queries tied to SQL databases. * Perform import and export routines to bring data into Access and Excel. * Develop new reports in Excel to internal and external use. Business Requirement Development and Regulatory Research * Analyze internal billing workflow procedures and processes. * Develop business requirements and technical specification documents for IT development. * Participate in new patient information system implementations for our clients. * Perform research on Medicare, Medicaid and Third Party Payer billing requirements and document findings. * Stay abreast of current trends and technical advancements.
Required Skills
* Database management skills and strong command of Microsoft Office products: * Advanced use of Excel using pivot tables, vlookup, hlookup, ifsum and string formulas. * Intermediate use of Access with knowledge of import/export routines, developing and running queries, etc. * Ability to integrate data between all Microsoft Office products including Access, Excel, Word and PowerPoint * Strong typing skills and efficient use of the keyboard and numeric keypad. * Strong analytical skills, including the ability to analyze, understand and summarize key issues. * Strong organizational and quantitative skills. * Ability to work as a team player in a dynamic, team-oriented, deliverable-focused, and professional environment. * Excellent oral and written communication skills. * Excellent work ethic with the ability to multi-task and prioritize work assignments. Required Experience
* Worked in a healthcare industry for 5 to 7 years with direct experience either working for a major third party payer or working for a healthcare provider such as hospitals and physician offices. * A Bachelor’s Degree in Accounting or Finance * Financial background with experience analyzing operating budgets, enrollment data, claims data, medical loss ratios, PMPM calculations, visit data, gross charges, etc. * Accounting background with experience in journals entries, month end close procedures, balance sheet reconciliations, profit and loss statement preparation, etc. This position may be subject to a background check Job Location Boston, MA, US. Position Type Full-Time/Regular
