Revenue Management Analyst

The Revenue Management Analyst is responsible for analysis and maintenance of revenue management systems, including the data collection, error tracking and resolution and other CMS regulations to ensure optimal risk reporting to CMS.  Performs various CMS reporting, ensuring completion, accuracy and timeliness is met.  Responsible for performing various revenue activities and analysis, develop and prepare various management reports and statistics.  Works closely with operations staff to assess status of all activities related to risk and member special status codes, which drive CMS reimbursement.  This position provides analytical expertise to the Team Leader of the unit, and Director as needed.  The Revenue Management Analyst acts as contact/liaison for other operating teams within the organization when Team Leader is unavailable. 

 

Essential Responsibilities/Accountabilities

 

· Uses applications to analyze CMS payment report data.  Identifies data trends.

 

· Performs calculations using CMS-HCC risk adjustment model.

 

· Conducts analysis of data to develop conclusions and baselines.

 

· Reviews and analyzes submissions to CMS, including response files, error tracking and resolution, and resubmission.

 

· Works closely with other departments to reconcile data and payments, while optimizing plan payment revenue within CMS guidelines.

 

· Develops and implements efficient processes as a Revenue Management unit.

 

· Develops comprehensive understanding of CMS revenue drivers, and oversees collaboration of analysis of revenue projections.

 

· Monitors status of new, existing and previous recovery situations.

 

· Consistently demonstrates high standards of integrity by supporting the Lifetime Healthcare Companies’ mission and values and adhering to the Corporate Code of Conduct.

 

· Maintains high regard for member privacy in accordance with the corporate privacy policies and procedures.

 

· Regular and reliable attendance is expected and required.

 

· Performs other functions as assigned by management.

 

Minimum Qualifications 

 

· Bachelor’s degree in Accounting/Finance, Mathematics or Statistics with a minimum of three years of relevant experience.

· Knowledge of Visual Basic and SAS experience required.

· Excellent interpersonal, organization, verbal and written communication skills.

· Flexibility.

· High-level analytical ability and demonstrated data management skills.

· Experience in heavily regulated environment is preferred.

 



In support of the Americans with Disabilities Act, this job description lists only those responsibilities and qualifications deemed essential to the position.

 

Equal Opportunity Employer