Reporting directly to the SVP Operations, while also deeply collaborating with the Operations & Clinical teams, the Revenue Cycle Analystwill play an integral role in streamlining the delivery engine of Sylvan Health. This person will manage patient billing and insurance claims for our partners and work cross-functionally across the operations and finance verticals. They will assist our operations team in implementing revenue cycle management best practice strategies, create reports with and for our partners, and analyze data to identify lost revenue and collect payments. This role requires knowledge about insurance coverage, a technical aptitude, and ideally have previously worked in a start-up environment.

REQUIREMENTS

RCM System Operations

• Support billing workflow for RDs, client success for patient resolution
• Provide expertise to create and sustain RCM support for Sylvan model

Claims submissions and adjudication

• Utilize multiple EHR systems as applicable to access claims reports for our partners and program
• Monitor and oversee monthly financial reconciliation processes for our partners in coordination with our operations team, client-facing as needed
• Build out and deliver our partner deliverables and requirements to empower optimal claims submission and billing for our programs; this includes but is not limited to sending partner claims files, reviewing and educating partners on billing best practices, and working with our operations team to empower our partners for optimal billing results
• Own and evaluate current and future billing processes and procedures to act as RCM consultant and guide
• Act as primary POC for RCM-related initiatives and communication alongside and in tandem with the Client Success Tea m

Skills and Abilities:

• Willingness to build from the ground up, growth mindset, and be willing to propose solutions
• Healthcare and Revenue Cycle Management knowledge, including but not limited to insurance coverage for examinations, accurate billing of insurance for providers and patients, diagnostic and treatment procedures, medical practice and terminology
• Ability to work independently, with effective communication across departments and other team members
• Ability to invest in change management processes, commitment to quality delivery, and attention to detail
• Technical Aptitude to navigate multiple technical systems to deliver quality and timely output
• Demonstrate an ability to listen and communicate with others in a professional and caring manner including sensitivity with individuals
• Demonstrate an ability to set priorities for tasks to work effectively despite interruptions and under minimal supervision
• Maintains strict confidentiality; following HIPPA regulations

Requirements:

• 3+ years experience in medical billing and revenue cycle management, or related healthcare field
• Nice to have: exposure to MNT billing and medical nutrition therapy expertise
• Background in healthcare, preferably with previous experience in a start-up environment
• Experience working within an ambulatory healthcare environment is a plus
• Legally authorized to work in the U.S

Please refer the Job description for details