Healthcare Revenue Optimization Analyst

UMC Health System

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Job Title: Healthcare Revenue Optimization Analyst

Department: Central Business Office

Location: Security Park B-27

Overview:

We are seeking a detail-oriented and analytical Healthcare Revenue Optimization Analyst to join our team. The ideal candidate will possess a strong understanding of medical coding principles, revenue cycle management, and healthcare reimbursement methodologies. The Healthcare Revenue Optimization Analyst will play a crucial role in ensuring accurate coding practices, optimizing revenue capture, and maintaining compliance with regulatory requirements.

Availability Requirements:

  • Ability to work 40 hours per week on site
  • Hours of duty may be irregular

Benefits: UMC Physicians offers a comprehensive benefits package to eligible full-time employees. Benefits include:

  • Paid Time Off
  • Sick Pay
  • Medical, Dental and Vision Insurance
  • Employer Paid Group Life and Voluntary Life Insurance
  • Short Term Disability Insurance
  • Long Term Disability (after 2 years of employment)
  • Critical Illness, Accident and Cancer Insurance
  • Health Care and Dependent Care Spending Accounts
  • 401K Retirement Plan with Company Match
  • Employee Assistance Program

Note: Some benefits require an employee contribution to participate.

Essential Job Functions:

  • Review and analyze medical records to ensure accurate coding of

diagnoses, procedures, and services rendered.

  • Conduct coding audits to identify discrepancies, coding errors, and

opportunities for improvement.

  • Collaborate with healthcare providers, coding staff, and revenue cycle

teams to resolve coding-related issues and discrepancies.

  • Monitor coding trends and industry changes to ensure compliance with

coding guidelines, regulations, and payer policies.

  • Perform root cause analysis for coding denials and rejections and i

implement corrective actions to mitigate future revenue loss.

  • Provide education and training to coding staff and healthcare providers on

coding guidelines, documentation requirements, and revenue optimization

strategies.

  • Assist in the development and implementation of coding policies,

procedures, and best practices to improve coding accuracy and revenue

integrity.

  • Generate reports and metrics to track coding performance, revenue trends,

and compliance with key performance indicators (KPIs).

  • Participate in revenue cycle improvement initiatives, process

enhancements, and technology implementations to streamline workflows

and maximize revenue capture.

  • Serve as a subject matter expert on coding and revenue integrity matters,

providing guidance and support to internal stakeholders as needed.

Qualifications:

  • Bachelor’s degree (preferred) in Health Information Management,

Healthcare Administration, or related field.

  • Certified Coding Specialist (CCS), Certified Professional Coder (CPC), or

equivalent coding certification required.

  • Minimum of 2-3 years of experience in medical coding, revenue cycle

management, or healthcare finance.

  • Proficiency in ICD-10-CM/PCS, CPT, HCPCS coding systems, and medical

terminology.

  • Strong analytical skills with the ability to interpret complex coding

guidelines, regulations, and payer policies.

  • Excellent communication skills with the ability to effectively collaborate

and communicate with multidisciplinary teams.

  • Detail-oriented with a high level of accuracy and attention to detail.
  • Proficiency in Microsoft Office Suite (Word, Excel, PowerPoint) and

experience with coding software and electronic health record (EHR)

systems preferred.

  • Knowledge of healthcare reimbursement methodologies, payer contracts,

and revenue cycle processes preferred.

Environmental Conditions:

Works in well-lighted, heated and ventilated building. Exposure to blood borne pathogens are of low risk.

Physical Requirements:

Work is of medium demand; walking and sitting most of the time while on duty. Adequate hand/eye coordination and fine motor skills required. Visual acuity and writing skills necessary for factual documentation. Hours may vary to

accommodate needs of the corporation

Limitations and Disclaimer

The above job description is meant to describe the general nature of work being performed; it is not intended to be construed as an exhaustive list of all responsibilities, duties and skills required for the position.

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UMC Health System provides equal employment opportunities to all employees and applicants for employment and prohibits discrimination and harassment on the basis of race, color, religion, age, sex, national origin, disability status, genetics, protected veteran status, sexual orientation, gender identity or expression, or any other characteristic protected by federal, state or local laws.

  • Request for accommodations in the hire process should be directed to UMC Human Resources.*

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