Revenue Analyst

Job Overview

The Revenue Analyst is responsible for analyzing claim and reimbursement issues to ensure all system processes are correct and accurate to maintain data integrity and compliance with all regulations. Acts as a liaison between departments and facilities to ensure maximum revenue is achieved. Completes special projects as requested by revenue cycle leadership. Coordinates between PFS, Revenue Integrity, and managed Care departments to increase collections and enhance revenue cycle process.

Accurately tracks and maintains internal and payer issues and relevant data to eliminate gaps. Works closely with payers and represents CHCO at payer JOC′s and other meetings with payers, to bring forward and solve for claims processing and reimbursement issues.

Department Name:
Patient Financial Services

Job Status:
Full time, 40 hours per week.

Shift: Day, Hybrid

POPULATION SPECIFIC CARE - No direct patient care.

• Interprets insurance carrier contract payment language and EOBs. Utilizes in depth knowledge of Commercial Managed Care and state Medicaid hospital reimbursement methodologies.
• Utilizing data analytics to identify trends, prepare reports and provides insights to leadership on revenue cycle performance and identified gaps. Provides recommendations and coordinates with appropriate departments and/or payers to resolve.
• Conducts research for unpaid charges to identify and correct billing errors to recover revenue. Ensures compliance with all applicable regulatory bodies.
• Identifies and reports inefficient or ineffective system processes or transactions and participates in the resolution of problems.
• Notifies leadership of issues related to system, payer and errors/correction processes. Develops and maintains current documentation and training of system correction processes.
• Utilizes knowledge of ICD-10, HCPCS and revenue coding to extract and analyze hospital data.
• Monitors Epic work queues and other reports to identify potential inconsistencies that require system and/or data correction. Initiates corrections as needed. Develops and implements strategies to streamline workflows, improve billing accuracy, and accelerate revenue collection.
• Works closely with all departments. Develops and maintains effective working relationships across departments, with community providers, payers and vendors to research and resolve reimbursement and data/billing discrepancies.
• Monitors billing regulations, policies and procedures to ensure compliance with payer requirements. Assists with analyzing billing practices and recommends changes.
• Ensures compliance with regulatory requirements and facilitates financial audits related to revenue cycle management.
• Participates in meetings, committees and department projects as assigned.

• Bachelor’s degree in Finance, Healthcare, Computer Science or related field.
• Three (3) years of experience in data analytics and/or operational analysis.
• Professional experience, beyond requirements, in a related field may substitute for a Bachelor’s degree requirement on a year for year basis.

Pay is dependent on applicant's relevant experience.

Annual Salary Range (Based on 40 hours worked per week): $57,184.55 to $85,776.82

Here, you matter. As a Children’s Hospital Colorado team member, you will receive a competitive pay and benefits package designed to take care of your needs that includes base pay, incentives, paid time off, medical/dental/vision insurance, company provided life and disability insurance, paid parental leave, 403b employer match (retirement savings), a robust wellness program, and access to professional development tools, including an education benefit to help you advance your career.

As part of our Total Rewards package, Children's Colorado offers an annual employee bonus program that rewards eligible team members based on organizational performance. If organizational goals are met for the year, the bonus is paid out the following April. Children’s Colorado delivers annual base pay increases to eligible team members based on their performance over the…