01Overview
Note: The job is a remote job and is open to candidates in USA. CenterWell Senior Primary Care is a leading healthcare services business focused on creating integrated and personalized care experiences. The Home Healthcare Revenue Cycle EDI Systems Analyst is responsible for supporting and optimizing revenue cycle systems, ensuring compliance with regulatory requirements, and collaborating with internal and external teams to enhance system functionality.ResponsibilitiesSupport and configure revenue cycle applications utilized for billing and claims managementIdentify and implement process improvements to reduce denials and accelerate reimbursementsCollaborate with FSU, IT and vendors to troubleshoot and resolve system issues and coordinate upgrades or integrationsMonitor revenue cycle metrics such as errors, rejections and denial ratesUtilize dashboards and reports to track and identify billing and collections trendsProvide actionable insights to leadership for decision-makingEnsure systems align with CMS, HIPAA, and payer requirementsRespond to internal and external audit and data requestsSupport staff with system use and system issuesManage, analyze, and optimize electronic data transactions (837, 835, 270/271, etc.) between the FSU and external vendorsCollaborate with clearinghouses and payers to resolve transmission, billing and adjudication errorsEnsure timely submission of claims and receipt of remittance advicePartner with internal and external teams to ensure system functionality supports departmental and company goalsWork with finance to reconcile payments and resolve discrepanciesSupport and train staff on System functionality, EDI processes and best practicesEvaluate current workflows and recommend enhancements to improve efficiency, reduce costs, and ensure accurate and timely billingCollaborate with cross-functional teams to implement new procedures and track effectivenessSkills3 or more years of experience in healthcare revenue cycle and EDI, preferably in home health or post-acute careStrong knowledge of HIPAA transactions (837, 835, 270/271, etc.), EMR/EHR systems, and clearinghouse platformsAnalytical skills with proficiency in Microsoft Office applicationsUnderstanding of healthcare regulations, reimbursement models, and compliance standardsExcellent problem-solving, communication, and organizational abilitiesBachelor's degree in Health Information Management, Computer Science, Business Administration, Healthcare Management, Data Analytics or related field, or equivalent experienceExperience with revenue cycle automation tools and workflow optimizationFamiliarity with Medicare/Medicaid billing processes specific to home healthProficiency in file transfer softwareProject management or process improvement experienceBenefitsMedical, dental and vision benefits401(k) retirement savings planTime off (including paid time off, company and personal holidays, paid parental and caregiver leave)Short-term and long-term disabilityLife insurance and many other opportunitiesCompany OverviewCenterWell Senior Primary Care is a hospital that provides senior care, residential care, and related medical services. It was founded in undefined, and is headquartered in Louisville, Kentucky, USA, with a workforce of 1001-5000 employees. Its website is https://www.centerwellprimarycare.com.
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