ABOUT THE COMPANY
Acumen is one of the nation's leading fiscal agents offering a portfolio of innovative financial management services backed by superior customer service. Our passion is to help people lead independent lives through exceptional participant-directed programs. Acumen is a great place to work. Our employees make a positive difference in our client's lives by what they do. Among many benefits to working here, we offer medical, dental, and vision coverage, generous paid time off, and incentive bonuses to those who qualify.
OVERVIEW AND ESSENTIAL JOB FUNCTIONS
The Revenue Cycle Management (RCM) Analyst will use analytical skills and attention to detail to drive success. They will use a proactive approach and growth mindset to work effectively across functions, influence upstream process, and work to improve claims acceptance rates.
Billing Optimization and Revenue Recovery:
- Analyze billing data to identify root causes of denials and inefficiencies, focusing on strategic improvements to increase claims acceptance rates, particularly for claims submitted to Centers for Medicare and Medicaid services
- Develop and implement solutions to optimize the billing cycle, ensuring compliance with strict medical billing guidelines and alignment with industry best practices
Advanced Data Analysis and Reporting:
- Utilize strong proficiency in data analysis tools to create sophisticated models and reports that provide deep insights into billing processes
- Prepare detailed presentations that track denial trends, analyze billing performance, and provide actionable insights to senior management
- Utilize strong root cause analysis (RCA) skills to identify and address system or process issues, providing actionable insights and solutions to improve overall efficiency and accuracy in billing and claims processes
Cross-Functional Collaboration:
- Work closely with various departments including Enrollment, Payroll Operations, Tax Operations, and General Ledger to understand and influence the processes that impact billing outcomes
- Advocate for necessary changes in upstream functions to reduce denials and enhance the efficiency of billing practices, ensuring alignment with billing requirements
- Support the implementation of Claims Manager by defining and optimizing related processes, and setting up comprehensive reporting to ensure smooth integration and operational efficiency
Process Improvement:
- Initiate process reviews and lead projects aimed at improving the overall efficiency and effectiveness of the billing processes
- Employ advanced analytical tools and methodologies to develop forecasts and models that predict potential future challenges in billing
- Other duties as assigned
- ALL Acumen employees will be vigilant to support the positive compliant cybersecurity company posture by familiarizing themselves with all policies, procedures, standards, and guidelines and act
