Senior Business Systems Analyst - Revenue Cycle and Claims
Job Summary
Job Description
The Senior Business Systems Analyst will collaborate with stakeholders to understand, document, and address data needs. They will map revenue cycle, clinical, and claims data to a normalized model and serve as a subject matter expert on revenue cycle data domains. Responsibilities include performing quality consultations, collaborating on data quality issue resolution, and assisting customers with their technology needs. The role involves designing and implementing projects requiring systems integration, conducting financial analysis, and driving improvement activities to meet departmental and organizational goals. The analyst will also monitor task assignments, identify areas for process improvement, and ensure tasks are completed on schedule and with quality.
Must have:
- Experience as a Revenue Cycle analyst in Healthcare.
- Working knowledge of relational databases/database structures, SQL experience desired.
- Strong understanding of data in EMRs, Revenue Cycle and Patient Accounting Systems.
- Knowledge of ambulatory and acute clinical, billing, and claims workflows.
Good to have:
- Bachelor or Masters degree in related health or finance field.
5 skills required
Job Details
Job Summary:
- Works with stakeholders to discover, clarify, and document current and future data needs
- Performs mapping of revenue cycle, clinical and claims data to a normalized data model.
- Serves as a subject matter expert on the revenue cycle data domains such as Registration, Scheduling, Accounting and Billing
- Builds data concepts to supports Revenue Cycle and Claims use cases
- 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 experience 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.
- 3 years of experience preferred
- High school diploma/GED with 2 years of experience, or Associate’s degree, or Bachelor’s degree require
Work Environment
This job operates in a professional office environment. This role routinely uses standard office equipment, including but not limited to, computers, phones, and photocopiers.
Physical Demands
This position requires the frequent and repetitive use of a computer, keyboard, and mouse. Hand and finger dexterity is required.
Other Duties
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.
EEO
Saama provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment of any type without regard to race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.
This policy applies to all terms and conditions of employment, including recruiting, hiring, placement, promotion, termination, layoff, recall, transfer, leaves of absence, compensation, and training.
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