Job Description
Since 1957, Shield Healthcare has provided high-quality healthcare services while focusing on customer satisfaction and employee achievement. We are dedicated to fulfilling the medical supply needs of consumers and the caregiving community while maintaining a 99% overall customer satisfaction rating. Over the years, Shield HealthCare has expanded nationally with current service locations in California, Colorado, Illinois, Ohio, Texas and Washington.
Shield HealthCare is looking for a Revenue Cycle Analyst to analyze the medical claims billing process, looking for ways to solve payer rejections and denials. Requires collaboration with cross departmental teams and strong problem solving/research skills. Assists with distributing department workflow, prioritizing projects, and achieving positive financial outcomes.
This is an on-site position in Valencia, CA.
JOB RESPONSIBILITIES:
Create advanced Microsoft Excel reports/models that highlight reimbursement results and trends
Gather and extract data from databases using AS400 queries, SQL queries, and Microsoft Power BI
Utilize trend and comparative analyses to address revenue cycle challenges, looking for ways to solve payer rejections, denials, and underpayments
Present quantitative and qualitative findings in a clear and concise manner
Collaborate with staff across the organization to solve problems and improve internal efficiencies
Establish positive relationships with third-party payers and clearinghouses to resolve billing issues
Quantify impact of new insurance payer contracts and billing requirement changes
Handle multiple priorities with aggressive deadlines, ensuring appropriate follow-up and closure
Prepare variety of ad-hoc reports and analyses as requested
Evaluate department processes for efficiency and accuracy
Share responsibility for effectively managing accounts receivable (A/R)
May be required to supervise a team of claims adjudicators/billing specialists, holding them accountable to achieve positive financial outcomes
QUALIFICATIONS:
Bachelor’s Degree in Business/Finance or equivalent work experience
3-5 years’ experience in an analytical role within finance, claims management, or medical billing preferred
Familiarity with various medical insurance payer guidelines/billing requirements is a plus
Proven ability to communicate results of analyses to management with great impact
Proficiency in Microsoft Office and advanced level of proficiency in Microsoft Excel
Strong analytical, organizational, and communication skills
Proven ability to research and solve problems
PAY & BENEFITS:
$35-40/hour
Medical, Dental, and Vision
401(k) with Company Match
Sick and Vacation Days
Flexible Spending Account
Life & Disability Insurance
Education Assistance
Employee Referral Program
Career-minded individuals will find our business challenging and our reputation for excellence just one of the rewards we have to offer. To further enhance this tradition of excellence, our employees participate in continuous training and development programs in a variety of disciplines.
Full-time