45 results for Revenue Cycle Analyst in El Segundo, CA
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The Revenue Cycle Analyst will be responsible for identifying and addressing revenue cycle inefficiencies, analyzing trends in payer performance, and resolving issues related to unpaid claims, denials, and appeals. The ideal candidate will have advanced knowledge of the revenue cycle process, including insurance collections, and the ability to provide strategic insight that improves operations and financial outcomes.
Key Responsibilities:
- Monitor and analyze revenue cycle performance, including claims submissions, payments, denials, and appeals.
- Work with insurance payers to resolve unpaid or underpaid claims, ensuring timely collection of reimbursement.
- Evaluate denial patterns to identify root causes and implement corrective actions to reduce or prevent future denials.
- Prepare and submit detailed appeals for denied claims, effectively communicating with payers to secure resolution.
- Collaborate closely with billing, coding, and patient registration teams to improve processes and minimize revenue leakage.
- Research insurance guidelines to ensure compliance with payer requirements and best practices.
- Generate detailed reports on key performance metrics, including days in accounts receivable (AR), denial rates, and collection trends.
- Provide recommendations to improve revenue cycle processes and contribute to the organization’s overall financial performance.
- Stay updated on changes in healthcare regulations, payer policies, and coding standards to ensure compliance.
- Proficiency in Electronic Health Records (EHR) systems and revenue cycle management tools (e.g., Epic, Cerner, Allscripts).
- Strong knowledge of insurance payer rules, claim adjudication processes, and reimbursement methodologies.
- Familiarity with medical coding principles (ICD-10, CPT, HCPCS) and billing regulations, including Medicare and Medicaid.
- Advanced analytical and problem-solving skills, with the ability to interpret data and identify actionable insights.
- Excellent communication and negotiation skills to effectively collaborate with team members, payers, and leadership.
- Strong organizational abilities, attention to detail, and ability to manage multiple priorities in a fast-paced environment.
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