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Lead Analyst - Revenue Cycle Ops

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Overview:
Central Maine Healthcare is seeking a Full Time, Lead Analyst to join our Revenue Cycle Ops team!

Position Summary:

Responsible for informing and supporting the strategic and operational leadership of the Revenue Cycle department. Contributes to the financial strength, compliance and overall performance of Revenue Cycle operations by providing information, analytics, reports, and best practice knowledge for the Revenue Cycle functions, including hospital and physician (provider) services. Provides assistance to the Senior Director Revenue Cycle by providing support and knowledge to the Director of Patient Access, the Director of Health Information Management and the Director of Patient Financial Services to ensure collaboration and alignment of the Revenue Cycle areas and workgroups. Serves in a key role to assist in monitoring and facilitating improvement in the overall quality, timeliness, completeness, and accuracy of Revenue Cycle processes (such as financial clearance, pre-registration, point of service collections, patient contact center operations, etc.). Data integrity, tracking issues, reporting of performance and impacts of improvement initiatives and standard KPIs is required. Ensures the effectiveness of Revenue Cycle policy, practices and technology platforms. The position will provide support to the Senior Director, Strategic Teams and Workgroups in the overall direction, coordination, issue tracking, goal tracking and evaluation of Revenue Cycle and may be specifically responsible for any of the following:
  • Hospital Check-In
  • ED Check In and Check Out
  • Practice Check In and Check Out
  • Point of Service Collections
  • Technology Requirements
  • Process Design
  • Alignment with all Revenue Cycle Initiatives
  • Staffing Models
  • Alternate Financing
  • Financial Counseling Referrals Process
  • Referral Process
  • Authorizations
  • Price Estimation
  • On-Line Scheduling and Check In
  • Workflow Design
  • Pre-Service Check In
  • Patient Service Contact Center
  • Vendor Management
  • KPI Dashboards and Reports
  • Updating Work plans and Monitoring Tasks and Goals
  • Strategic Design of Revenue Cycle Operations

It is critical that this position be highly effective in delivering the services described above and work harmoniously with leaders and staff across the organization. Effectiveness will be measured in terms of measurable results, commitment, staff engagement and customer satisfaction (at all levels).

Education and Experience:

  • Bachelor’s degree required, or eight (8) years related experience in lieu of, and Five (5) years of experience in Finance or Revenue Cycle.

Knowledge, Skills and Abilities:

  • Detailed knowledge of privacy and security regulations, confidentiality/HIPAA, payer registration/authorization requirements, State Charity Care compliance, and MaineCare compliance regulations.
  • Working knowledge of Medical Terminology, Current Procedural Coding (CPT, HCPCS), Diagnostic Coding (ICD-9, ICD-10).
  • Expertise with regulations and accreditation standards, knowledge of specific state and federal requirements and standards.
  • Working knowledge of Medical Record, Financial Services and Healthcare Application technology.
  • Demonstrated experience in diagnosing, evaluating and developing corrective actions for problems in operations.
  • Able to effect collaborative alliances and promote teamwork.
Equal Employment Opportunity:

CMH actively promotes diversity in its workforce at all levels of the organization. We strive to create and maintain a setting where we celebrate cultural and other differences and consider them strengths of the organization. CMH is an equal opportunity workforce and no one shall discriminate against any individual with regard to race, color, religion, sex, national origin, age, disability, sexual orientation, gender identity, genetic information or veteran status with respect to any offer, or term or condition, of employment. We make reasonable accommodations to the known physical and mental limitations of qualified individuals with disabilities.

About Central Maine Healthcare:

Central Maine Healthcare is an integrated healthcare delivery system serving 400,000 people living in central, western and Midcoast Maine. CMH's hospital facilities include Central Maine Medical Center in Lewiston, Bridgton Hospital and Rumford Hospital. CMH also supports Central Maine Medical Group, a primary and specialty care practice organization. Other system services include the Central Maine Heart and Vascular Institute, a regional trauma program, LifeFlight of Maine's southern Maine base, the Central Maine Comprehensive Cancer Center and other high-quality clinical services.

Employment Status: Full Time Shift: Days

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