Medically Home operates a decentralized care model for patients with serious, complex or high-risk illnesses in partnership with health systems to safely care for their patients at home, across the care continuum, including hospital-level care. Medically Home provides health systems with all that is needed to safely care for patients, including the clinical protocols, reimbursement model, platform technology, and fulfillment of all the clinical services required in the home through partners. Clinicians and patients broadly prefer this model over traditional care; both clinical and financial outcomes are improved as compared to traditional care.

Medically Home's Payor and Revenue Cycle Enablement Team is responsible for creating and executing the roadmap for our customers’ contracts with payor partners as it relates to the Medically Home model. We also have a participating provider model for both acute substitution and ED in the Home care that requires end to end revenue cycle services. The Medically Home models requires support for both our health system customers’ and our internal revenue cycle processes. As a key member of our team, you will be on the front lines of bringing the Medically Home model to our health system customers and payor partners. You will enable support of critical customer revenue cycle requirements and internal revenue cycle operations across all markets.

Job Description:

Medically Home Group seeks a strong Revenue Cycle Analyst to be an integral part of the revenue cycle team at Medically Home with responsibilities to one or more of the following functions: coding, charge capture, documentation review, billing, follow up, and charge analysis. This position is focused on Medically Home’s internal revenue cycle needs; the job requires an individual with a thorough understanding of mid-cycle and back-end processes. The Revenue Cycle Analyst will work with Rapid Response Services (RRS) and Finance to ensure timely, clean claim submission.

Reports to: Director of Revenue Cycle Enablement
Location: Remote
Travel: Required based on customer implementation need (National)

Key Duties and Responsibilities:

The successful candidate will be a flexible team player, who can provide consistent, timely results while understanding the unique needs of each internal and external customer. The individual will, at a minimum:

• Review charges and validate with clinical documentation

• Identify and escalate charge or clinical documentation issues

• Construct claims in accordance with billing guidelines

• Ensures accurate and timely claim submission

• Works collaboratively with the RRS and Finance to ensure clean claim construction

• Participates in huddles with Rev Cycle staff

The successful candidate will have experience in the following areas:

• Production coding and billing experience for a hospital or medical group provider

• Meeting productivity standards while maintaining accuracy and adhering to applicable guidelines

• An understanding of mid-cycle processes (e.g., charge triggers, charge interfaces, movement of charges on to hospital billing records, etc.)

• An understanding of back-end processes (e.g., claim combination, claim edits and modifiers, clearinghouse requirements, etc.)

• Ability to analyze charge data, identify variances and present findings in a clear, concise manner

The ideal candidate will, in addition to the above:

• Have 3 years of experience in the revenue cycle space, preferably across the front end, mid-cycle, and back-end processes

• Ability to work autonomously

• Advanced MS Excel skills

• Ability to research coding and billing topics; prepare recommendations on correct code assignment and documentation requirements

• Proven track record of meeting performance targets

• Active CPC, CPMA, CCS, CCS-P, CRC, or CRCR certification

Requirements:

• Healthcare revenue cycle experience as described above

• A desire to transform healthcare in the service of patients and their families

Consistent with Medically Home’s values of serving our patients, customers, and team members, Medically Home has implemented a vaccine policy consistent with those commitments. Therefore, all MH colleagues need to provide evidence of vaccination against seasonal influenza and COVID-19. Individuals who are unvaccinated against COVID-19 or previously received only monovalent vaccine doses (primary two dose vaccine series) are required to receive 1 bivalent mRNA vaccine dose.

At Medically Home, we are committed to creating a diverse and inclusive environment.? If you are excited about this role or about our company’s mission but you aren’t sure if your past experience ticks all the boxes in this job description - apply anyway.? You might just be the right candidate for this or other opportunities in our organization.

Medically Home is an equal employment opportunity employer and is committed to maintaining a non-discriminatory work environment. Medically Home does not discriminate against any employee or applicant for employment on the basis of race, color, religion, sex, national origin, age, disability, veteran status, marital status, sexual orientation, gender identity, or any other characteristic protected by applicable federal and/or state law.