HIM Data Analyst

POSITION SUMMARY:

The HIM Analyst will be the direct data analytics partner for the Revenue Cycle Operations team. This position will be responsible for gathering and analyzing data from multiple reporting sources and will input and compile data to track, trend, and forecast metrics. This position will help optimize Accuity revenue cycle data integrity by evaluating, validating, and trending data for presentation to all levels of the organization.

PRIMARY JOB RESPONSIBILITIES:

• Actively participates in special projects or deliverables assigned by management to analyze, track, and trend both internal and external data
• Combines data from multiple reporting sources to identify trends and opportunities based on data driven metrics
• Translates complex analytical tasks into actionable insights and easily understood outputs
• Performs data entry and update demographic information in the select internal systems
• Actively and skillfully conceptualizes, applies, analyzes, synthesizes, and evaluates information gathered from, or generated by observation, experience, reflection, reasoning, or communication as a guide to validate review results/findings and correct, as necessary
• Review scope includes validation of the MS-DRGs and APR-DRGs assigned for Medicare, Medicaid, commercial, and third-party claims
• Develops and maintains a strong understanding of Accuity and of client specific technology, policy, procedures, guidelines, and workflows
• Tracks and trends billing statuses, final outcomes, and reports this information in a clear and concise manner to all levels of the organization
• Prepares and maintains a variety of communications, tip sheets, reports and records while ensuring confidentiality of financial and medical records.
• Provides feedback to Accuity teams and team leaders on specific encounter outcomes as well as any overall trended opportunities
• Meets or exceeds short-term and long-term goals as established for the department
• Participates in staff meetings and attends other meetings and seminars as required
• Assist in special projects and other roles and responsibilities as needed to support Accuity
• Performs miscellaneous job-related duties as assigned

POSITION QUALIFICATIONS:

Education:

• High school diploma or GED required
• Associate's or Bachelor's degree in Healthcare Administration or related field preferred

Experience:

• Minimum of 2 years of experience in healthcare billing and collections
• Minimum of 2 years of experience with generic accounting, transactions, or medical billing systems (preferred)
• Knowledge of medical billing codes, insurance policies, and reimbursement procedures
• Excellent communication skills, both verbal and written
• Strong attention to detail and ability to prioritize tasks
• Advanced proficiency in Microsoft Office Suite (Excel) required
• Experience with PBAR, ACE, and/or FinThrive applications (preferred)
• Ability to work independently and as part of a team
• Knowledge of HIPAA regulations and compliance requirements

Licensure and/or Credentials:

• HFMA (Healthcare Financial Management Association) certification preferred
• CRCR (Certified Revenue Cycle Representative) certification preferred

Knowledge, Skills, and Abilities:

• Expert knowledge of Healthcare Revenue Cycle processes, specifically inpatient (IP) billing, rebilling, denials, and overall account adjudication processes and standards
• Understanding of Official Coding Guidelines, advanced knowledge of APR and MS DRG reimbursement models, state, and federal regulations
• Advanced knowledge of medical coding, electronic medical record systems, and coding systems
• Knowledge of quality assurance concepts and principles
• Knowledge of legal, regulatory, and policy compliance issues related to medical coding and documentation
• Ability to use independent judgment and to manage confidential information
• Ability to analyze and problem solve
• Detail oriented with ability to multi-task
• Strong communication (written and oral) and interpersonal skills
• Ability to use a PC in a Windows environment, including MS Word, Excel, PowerPoint, Teams, Outlook, etc.
• Able to execute under the pressure of time constraints and maintain focus over period of work hours
• Demonstrates ability to work independently as well as cooperatively with various teams
• Serves as a professional role model for internal and external customers