Job Description

Job Description

Job Description

Gaylord Specialty Healthcare is a health system dedicated exclusively to medical rehabilitation. We provide inpatient and outpatient care for people at every point in their journey from illness or injury to the most advanced state of recovery they can achieve. Our Mission: To enhance health, maximize function, and transform lives. Our values: Integrity, Compassion, Accountability, Respect and Excellence. These values guide us in providing quality patient care and transforming the lives of our patients.

Job Summary:

The Senior Revenue Cycle Accounts Receivable (A/R) Analyst is responsible for analyzing, managing, and optimizing the accounts receivable process to ensure timely and accurate reimbursement for Gaylord Hospital. This role involves monitoring key performance indicators, identifying trends, overseeing the resolution of claim denials and collaborating with various teams to improve revenue cycle efficiency. The Senior Analyst will play a vital role in maintaining Gaylord Hospital's financial health by maximizing revenue and ensuring the timely collection of cash.

Essential Duties & Responsibilities:

A/R Analysis and Monitoring :

• Monitor key performance indicators (KPIs) including Days in A/R, claim denial rates, clean claim rates and collection rates, identifying trends and areas of improvement.
• Perform aging analysis of outstanding claims, prioritizing collection efforts based on aging and payer
• Analyze denial trends to determine root cause and collaborate with relevant departments to resolve issues
• Develop a strategic approach to effectively monitor areas of opportunity/risk.
• Analyze, investigate and resolve payment variances, comparing actual payments received with expected payments based on contracted amounts
• Perform financial analyses for strategic initiatives and contract negotiation

Collaboration and Communications:

• Communicate findings and recommendations to management, providing insights and data-driven solutions for optimizing the revenue cycle
• Monitor vendor activity and collaborate with payer representatives to address issues and keep abreast of changing regulations and guidelines
• Coordinate and oversee processes related to billing, cash collections and payment posting working closely with revenue cycle team members to address issues and improve processes.

Process Improvement and Compliance:

• Perform Quality Assurance on billing and collection activities to provide feedback and make recommendations
• Develop training and education, and assist in the performance management of back-end revenue cycle specialists to ensure competency, productivity, and quality.
• Collaborate with specialist, IT and other departments to develop new workflows and strategies to improve processes and create efficiencies

Chargemaster:

• Update and maintain the Charge Description Master to reflect current services and pricing.
• Ensure compliance with billing and coding regulations

Other duties as assigned .

Qualifications:

• A bachelor's degree preferably in healthcare administration, business, or a related field. Equivalent experience may be considered.
• 5 years of experience in revenue cycle management preferred.
• Leadership experience preferred
• Strong knowledge of medical billing, healthcare regulations, reimbursement methodologies, and payer contracts
• Excellent analytical and problem-solving, and communication skills.
• Proficiency in Excel required
• Detail-oriented and organized, with the ability to manage multiple tasks and prioritize effectively.
• Strategic thinking and process improvement orientation

Certificates:

Certification in healthcare revenue cycle management (CRCR) preferred.

Hours:

Full time/Monday-Friday

We Are An Affirmative Action Employer – M/F/D/V

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