Business Analyst-Revenue Cycle and BAR-8135

The Revenue Cycle Billing and Accounts Receivable (BAR) Analyst is responsible for managing patient accounts throughout the post-service revenue cycle, including billing, claims management, denial resolution, accounts receivable follow-up, and reimbursement optimization. This role utilizes the MEDITECH electronic health record (EHR) and Patient Accounting (PA/RCG) applications to ensure accurate claim submission, timely collections, and compliance with payer and regulatory requirements.

The BAR Analyst collaborates with Registration, HIM/Coding, Case Management, Clinical Operations, and Patient Financial Services teams to identify and resolve billing issues that impact reimbursement and revenue integrity.

Billing and Claims Management

• Utilize MEDITECH Patient Accounting and Revenue Cycle applications to review, edit, and process claims.
• Ensure accurate claim generation and electronic claim submission to Medicare, Medicaid, commercial payers, and managed care organizations.
• Validate patient demographics, insurance coverage, authorization requirements, and charge capture information prior to claim submission.
• Coordinate with HIM and Coding staff to resolve coding and documentation deficiencies impacting reimbursement.

Accounts Receivable Follow-Up

• Manage assigned insurance and patient A/R accounts using MEDITECH work queues and follow-up functionality.
• Investigate unpaid, denied, partially paid, or rejected claims.
• Work denial management queues and submit appeals with supporting documentation.
• Identify root causes of denials and recommend workflow improvements.
• Maintain account documentation and follow-up activities within MEDITECH.

Revenue Integrity and Optimization

• Review reimbursement variances and payment discrepancies.
• Monitor claim status through clearinghouses and payer portals.
• Analyze denial trends and recurring claim edit issues.
• Assist with implementation of corrective actions to improve clean claim rates and reduce A/R days.
• Support revenue cycle performance initiatives and key performance indicators (KPIs).

MEDITECH System Responsibilities

• Serve as a subject matter resource for MEDITECH Patient Accounting and Revenue Cycle workflows.
• Troubleshoot billing, charging, and reimbursement issues within MEDITECH; support implementation and maintenance of MEDITECH dictionaries, billing rules, claim edits, and payer configurations as appropriate.
• Participate in revenue cycle system enhancement projects and end-user training; assist with testing, upgrades, optimization efforts, and workflow improvements.

Education: Bachelor’s degree in Business or a Healthcare related field strongly preferred. Certification or experience will be considered in lieu of a degree.

Experience: 5 years of healthcare billing, accounts receivable, patient financial services, or revenue cycle experience; experience with hospital billing, professional billing, or both; familiarity with Medicare, Medicaid, commercial insurance, and managed care reimbursement methodologies.

Education: N/A

Experience:

• Experience working within MEDITECH Patient Accounting and Revenue Cycle applications preferred; experience supporting revenue cycle workflows across Registration, HIM, Abstracting, Charging, Billing and Collections; experience building and maintaining revenue cycle dictionaries and billing parameters.
• Familiarity with MEDITECH Expanse Revenue Cycle implementation or optimization experience; MEDITECH NPR and Data Repository reporting.
• Knowledge of MEDITECH BAR, Claims Management, Insurance Follow-Up, and Denial Management worklists.

• Working knowledge of insurance eligibility and authorization processes; working knowledge of ICD-10-CM, CPT, and HCPCS coding structures.
• Ability to sit for six to seven hours daily; occasionally lift and carry up to ten pounds of files/boxes
• Ability to maintain composure in difficult and stressful situations.