Clinical Revenue Management Analyst

Job Summary

To support the Clinical Revenue Management Department, the full-time Clinical Revenue Management Analyst will manage daily assignments for department nurses, oversee inpatient case reviews, and ensure timely processing of reviews to maximize payor reimbursement, all while working remotely.

Key responsibilities

• Create daily assignments for nurses and manage inpatient case reviews based on priority
• Maintain accurate logs of denials and appeal decisions while ensuring timely processing of CRM reviews
• Communicate with payor representatives and coordinate follow-ups on outstanding denials and issues

Required qualifications

• Bachelor's Degree in Health Information Management, Business, or a related field
• Minimum of two years of experience in reviewing, auditing, or analyzing electronic medical records in an acute healthcare setting
• Advanced skills in Microsoft Office products
• Experience with Epic strongly preferred
• Working knowledge of third-party and prospective payment systems preferred