Job Description

Consultant Technical Analyst - Revenue Cycle and Claims

Job Summary:

o Works with stakeholders to discover, clarify, and document current and

future data needs

o Performs mapping of revenue cycle, clinical and claims data to a

normalized data model.

o Serves as a subject matter expert on the revenue cycle data domains

such as Registration, Scheduling, Accounting and Billing, Cost

Accounting and Claims

o Builds data concepts to support Revenue Cycle and Claims use cases

o Serves as a key resource for an assigned customer area to understand

and explain business and technical issues and to provide viable

technology solutions.

Responsibilities:

Act as a quality consultant and subject matter expert, performing

testing and validation of the mapping of data elements to standards

Collaborates with technical resources to perform root cause analysis

and complete remediation of data quality issues

Works with customers to clarify and plan for their current and future

technology needs. Determines and maps existing business

processes/functions and recommends changes required to fit a tightly

integrated system.

Designs and implements projects requiring systems integration, small

teams and multiple technical platforms.

Conducts Return on Investment (ROI) and other financial analysis to

support project funding/prioritization.

Collaborates on driving improvement activities to achieve department

and organizational goals.

Coordinates with functional team to assure consistency and

optimization of overall work product

Assumes a proactive role in driving improvement activities to achieve

department and organizational goals to deliver value.

Maintains current knowledge of industry and business process trends

and is able to apply that knowledge to existing business processes.

Provides subject-matter expertise of Health Ministry processes, policies

and requirements in support of functional area process design, testing

and implementation

Identifies opportunities for process improvement and makes

recommendations that lead to improvements

Monitors task assignments to ensure they are performed on schedule,

within intended scope and to a defined level of quality.

Escalates process and project issues that cannot be resolved

Experience:

Prior experience working as a Revenue Cycle analyst in the Healthcare

system.

Must have a working knowledge of relational databases/database

structures, SQL expertise desired

Must have a strong understanding of data collected and used in EMRs,

Revenue Cycle and Patient Accounting Systems.

Knowledge and experience with ambulatory and acute clinical, billing

and claims workflows and clinical information systems.

Bachelor or Masters degree in related health or finance field ex

informatics or bioinformatics.

Complexity of work: Within the scope of job, requires critical thinking

skills, decisive judgment and the ability to work with minimal

supervision. Must be able to work in a stressful environment.

* 5 years of experience preferred