Revenue Cycle Analyst Job at PathGroup, Brentwood, TN

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  • PathGroup
  • Brentwood, TN

Job Description

JOB SUMMARY:

The Research Analyst is responsible for medical records, quality assurance/utilization review and audit preparation. The Research Analyst also provides general support for the Coding Department.

JOB RESPONSIBILITIES

ESSENTIAL FUNCTIONS:
  • Provide accurate data for Legal requests, such as ledgers, itemized statements, 1500s and medical records as quickly and accurately as possible.
  • Retrieve activities for the HEDIS requests.
  • Ability to accurately interpret medical documentation to ensure they are providing accurate data requested (lab results/orders).
  • Review Pre and Post payments.
  • Provide a detail-focused review of clinical documentation to ensure quality, regulatory compliance, and audit readiness. Maintain all medical records and charts.
  • Assist in utilization review and research programs.
  • Handle documentation management to ensure documents received by the coding department are scanned into the correct patient chart.
  • Assist the department in requesting additional clinical documentation if needed.
  • Abide by all regulatory, company and departmental regulations, policies and procedures, including the Corporate Compliance Program.
  • Contribute to a positive work climate and to the team effort of the department and company.
  • Support PathGroup's mission, vision, goals and management decisions.
  • Become familiar with and abide by the Corporate Compliance Program and all corporate policies, including the Privacy and Security policies.
NON-ESSENTIAL FUNCTIONS:
  • Work with other departments within PathGroup and subsidiaries.
  • Nothing in the job description restricts management's right to assign or reassign duties and responsibilities to this job at any time.
  • Other duties as assigned.
EDUCATION & LICENSURE:
  • High school diploma or GED is required.
REQUIREMENTS:
  • One to two years of job-related experience is required.
  • PC proficiency required.
  • Ability to prioritize projects appropriately and attentiveness to detail required.
  • Effective oral and written communication skills and excellent interpersonal skills required.
  • Ability to learn and adapt quickly, strong attention to detail, and ability to maintain confidentiality
  • Excellent organizational and computer skills, as well as spoken and written communication skills
  • Ability to work effectively as a team member and meet tight time deadlines

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