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Revenue Cycle Analyst

Facility: CHS Services Inc Location: Melville, NY Department: Revenue Cycle Administration Category: Administrative / Business Support Schedule: Full Time Shift: Day shift Hours: 8-4 or 9-5 ReqNum: 6019604

Catholic Health Services of Long Island (CHS) is an integrated health care delivery system with some of the region's finest health and human services agencies. CHS includes six hospitals, three skilled nursing facilities, a regional home nursing service, hospice and a multiservice, community-based agency for persons with special needs. Under the sponsorship of the Diocese of Rockville Centre, CHS serves hundreds of thousands of Long Islanders each year, providing care that extends from the beginning of life to helping people live their final years in comfort, grace and dignity.

Position Summary:

Manage underpaid insurance balances that are unable to be resolved through routine follow up activities. Position requires a thorough understanding and knowledge of managed care contracts, practice and policy.

Job Responsibilities:

  • Contributes to and consistently applies CHS Services' policies, procedures, and benefits to all customers and/or employees without discrimination.
  • Employee conducts himself/herself in conformity with the HIPAA Compliance Program and applicable institutional policies and procedures for patient privacy. In addition, employee conducts himself/herself in conformity with the CHS Security policies and procedures.
  • Quantify and communicate trends in payer activity
  • Assist in the validation of contracts as loaded in contract management systems
  • Works with Managed Care Directors on recovery efforts tied to identified variances.
  • Conducts follow up activities with payers as assigned.
  • Conducts rate analysis for rate recycling.
  • Prepares and maintains revolving spreadsheets.
  • Prepares settlement files.

Requirements and Qualifications:
  • Bachelor's degree preferred, comparable work experience considered in lieu of bachelor's degree.
  • Proficient in designing, building reports and analyses in various Microsoft based data analysis tools. Proven experience working with large and complex SQL databases preferred.
  • Ability to analyze and accurately summarize complex claims data and effectively communicate conclusions
  • Previous experience with analysis preferably in a healthcare or managed care setting.
  • Experience with hospital billing and or decision support systems a plus.
  • Strong knowledge of the managed care environment including provider, payer, and employer.
  • Ability to work interdepartmentally and independently
  • Ability to work on multiple projects in a fast paced environment

At Catholic Health Services of Long Island your well-being comes first, with comprehensive compensation and benefits; our offerings go beyond the basics. In addition to multiple medical plans, life insurance, generous paid time off and flexible spending accounts, we also offer substantial tuition reimbursement, an employer funded pension plan and several savings plan options for your future.

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