Senior Revenue Cycle Analyst (System Application Analyst, Sr)

About this role

Department Overview
The Hospital Sr Revenue Cycle Analyst is responsible for the implementation, optimization, monitoring, and ongoing maintenance of Epic Revenue Guardian functionality to support compliant charge capture, revenue integrity, and reimbursement optimization across OHSU and its affiliates. This role serves as the primary subject matter expert for HB Epic Revenue Guardian and works collaboratively with the Revenue Cycle Team, Clinical Operations, Patient Financial Services, Coding, Compliance, Clinical Informatics, and Information Technology teams to identify revenue leakage, mitigate billing risks, and improve revenue cycle performance.
Function/Duties of Position
HB EPIC Revenue Guardian Analysis, Design & Development

• Perform system analysis, design, build, validation and ongoing maintenance of the Resolute HB Revenue Guardian Rules and WQs.

• Configure, maintain, and optimize Epic Revenue Guardian rules, account and charge review work queues, and reconciliation processes.

• Analyze and resolve Revenue Guardian alerts, exceptions, and system-generated charge issues.

• Design and implement automated controls to improve charge capture accuracy and reduce revenue leakage.

• Monitor Revenue Guardian performance and continuously refine business rules to improve outcomes.

• Collaborate with Revenue Cycle system analysts to deploy upgrades, enhancements, and system changes.

Problem Resolution

• Identify trends in missed, incorrect, duplicate, or delayed charges and recommend corrective actions.

• Work with analysts to investigate problems to determine if it is necessary to resolve, if needed, escalate it to leadership.

• Communicate problem progress and resolution.

• Thorough documentation of decision outcomes.

• Timely resolution of WQs and attention to root cause resolution to prevent ongoing charge lag issues.

Data Analysis and Reporting

• Analyze large datasets to identify operational trends, financial risks, and improvement opportunities.

• Present findings and recommendations to leadership, revenue cycle analysts, departments, and other stakeholders.

• Monitor productivity, charge lag and volume using various Epic system tools and reports. Identifies and helps prevent backlogs and other impediments to charge capture. Monitors charge review work queues daily to prospectively identify problems, potential backlogs and take the necessary steps to mitigate impact.

Collaboration & Support

• Work collaboratively with clinical areas, Financial Services, Health Information Services, Information Technology Group, and Charge Master Analysts to identify and resolve charging issues and revenue opportunities when applicable.

• Provide training/mentor assistance to lower-level analysts

• Serve as a member of the Revenue Cycle Team. Promote a customer service focus.

• Demonstrate cooperation, adaptability, flexibility, effective communication and dependability in supporting team goals.

• Participate in Revenue Cycle projects as directed by Revenue Integrity Assistant Director and Director.

• Other duties as assigned.

Certification and Continued Professional Development

• Epic certification in a Revenue Cycle Application (HB Resolute) within one year. Maintain EPIC Certification one achieved.

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Participate in appropriate activities that enhance general knowledge of or ability to do assigned work. This includes but is not limited to the following:

• Attend classes, seminars and other training forums as directed by supervisor;

• Attend staff meetings and other informational sessions; read vendor documentation, trade publications or other sources appropriate to position;

• Interact with peers and other employees to receive and disseminate information.

Required Qualifications

• Master’s degree in computer science, a related field, or a clinical field & 4 years' work related experience in the IT field or a combination of clinical or operational healthcare environments; OR

• Bachelor’s degree in computer science, a related field, or a clinical field & 6 years' work related experience in the IT field or a combination of clinical or operational healthcare environments; OR

• Associate’s degree in computer science, a related field, or a clinical field & 7 years' work related experience in the IT field or a combination of clinical or operational healthcare environments; OR

• 8 years' work related experience in the IT field or a combination of clinical or operational healthcare environments; OR

• Equivalent combination of education and applicable experience where one year of experience will be substituted for an Associate’s degree and two years of experience will be substituted for a Bachelor’s degree.

• Extensive knowledge of CPT-4, HCPCS, ICD-10 and Revenue coding.

• UB04 form requirements.

• Verifiable knowledge of the Outpatient Prospective Payment System.

•
Epic Certification in Revenue Cycle application (Resolute HB) within six months, and
evidence of continuing education.

Preferred Qualifications

• Experience implementing an Integrated Enterprise Hospital System (Admitting, Scheduling, Billing, CPOE, Documentation, etc) preferably Epic.

• Experience implementing technology that promoted fundamental changes in hospital settings.

• Working knowledge and understanding of project coordination and management.

• Working knowledge of content areas (i.e. Admitting, Hospital Billing, Registration, Scheduling, Nursing, etc.)

• Ability to function effectively in a very dynamic team environment.

• Ability to proactively pursue problem resolution to satisfy customer needs.

• Ability to proactively discover/test/analyze new Epic application enhancements/features independently.

• Ability to provide highly critical quality analysis and testing of new software applications or feature (including beta testing).

• Ability to manage multiple complex tasks efficiently while successfully meeting assigned deadlines.

• Ability to work with users to accurately assess…