REVENUE ANALYST - CLINIC - HOAG CLINIC ADMINISTRATION (Costa Mesa, CA, US)
Company: Hoag Memorial Hospital Presbyterian
Location: Costa Mesa
Posted on: June 10, 2021
The Revenue Analyst is a technical expert relative to Government
and Managed Care Facility reimbursement, including overall revenue
cycle reporting with emphasis on AR management.
As part of the Finance Revenue team, this position will support
Managed Care Contracting for contract modeling and revenue impact
analysis in support of negotiations, helping to identify
underpayments, and tracking profitability within our contract
models. This position will also prepare analyses related to the
financial impact of Medicare and Medi-Cal changes in reimbursement
in order to identify financial and/or operational impacts to
This position will also have responsibilities to support Revenue
Cycle by having direct and in-direct oversight for the
identification, coordination and execution of various analytical
processes within Revenue Cycle. The position will utilize multiple
data repositories to develop reports and trend analysis for
on-going accurate and actionable data for AR management and to
ensure financial and strategic objectives are consistently met. The
incumbent will manage month-end reporting of Revenue Cycle
operating results, compiles financial dashboards and write
narratives of findings for presentations to Hoag Clinic
As part of other on-going responsibilities, the position will
support the Revenue Finance Team with:
Adhoc revenue impact analysis.
Assist as requested with month end financial analysis.
Provide support in the development of each year's Operating
The individual projects an image of professionalism in
communication, appearance, and conduct and supports the department
and organization's mission and vision. Willing and capable to work
independently and in a team environment is essential. Task lists
management; accomplishing quality results on time in a high demand
environment are required. The position will act as a financial
resource for leadership across all business units.
- Supports Managed Care Contracting proposed negotiations by
modeling payor contracts in an effort to identify effective rate
- Prepares analysis related to the financial performance of
existing Managed Care contracts, in order to identify the financial
performance of those agreements. Recommends areas of
- Perform monthly capitation payment reconciliation for all
commercial and Medicare Advantage payers and follow up with payers
as needed to obtain accurate capitation payments.
- Analyze shared risk pool arrangements and facilitate periodic
- Develop accrual process for Mid-year and Final RAF adjustments
to minimize unexpected revenue fluctuations.
- Coordinates communication within the department and between
departments regarding changes in existing or new Managed Care
- Compiles daily, weekly, and monthly statistical reports
necessary for successful management of Revenue Cycle Operations and
- Possess expert analytical skills necessary to evaluate material
variances, trends, and correlations in A/R, revenues,
reimbursement, and volumes.
- Assists in projecting Hoag Net Patient Revenue for the
Operating Budget, Long Range Financial Plan and Month End Close, as
- Serves as a financial resource for clinical and non-clinical
- Perform other duties as assigned.
Education, Training and Experience
- Bachelor's degree in business administration, finance,
accounting, or healthcare administration.
- 3-5 years' experience as an analyst in a healthcare environment
with emphasis on provider revenue and reimbursement
Skills or Other Qualifications
- The individual possesses a strong understanding of Managed Care
and Government reimbursement methodologies. Exhibits a working
knowledge and understanding of different reimbursement
methodologies such as fee-for-service, capitation, case rates,
- The individual has a solid understanding of hospital Revenue
Cycle: Patient Accounting/Billing, AR management, and claim data
processing). Proven excellent communication and customer service
skills, including the ability to progressively investigate, analyze
and identify sources of problems, provide practical solutions, and
- Strong computer technical skills required, including
proficiency with Microsoft Office products (Excel, Access, and some
PowerPoint), Allscripts EPSI and EPIC knowledge a plus.
- Skilled at analyzing large data sources; strong SQL/SAS
- Ability to make independent business decisions, considering
both the impact to client satisfaction and overall financial impact
for the department and organization. Ability to streamline
processes for efficiency. Strong analytical aptitude and experience
creating financial models. Possesses good sense of general business
- Strong understanding of DRG and CPT/HCPC Medical Coding and
- Basic understanding of Accounting Principles and Hospital
- Familiarity with Medicare Risk Adjustment process.
License and Certifications
Position Reports to: Director of Health Plan Revenue
Keywords: Hoag Memorial Hospital Presbyterian, Costa Mesa , REVENUE ANALYST - CLINIC - HOAG CLINIC ADMINISTRATION (Costa Mesa, CA, US), Other , Costa Mesa, California
Didn't find what you're looking for? Search again!