Revenue Cycle Analyst

OCES is growing! We are expanding to 11 more towns covering the southshore area, including Quincy, Braintree, Weymouth, etc. APPLY NOW duringthis exciting time! OCES supports older adults and individuals withdisabilities by providing vital information and coordination ofservices. By promoting healthy, safe living for our consumers, we hopeto allow them to stay active and engaged in their lives and in their owncommunities for as long as possible. Our mission: Through the talents ofan experienced and diverse workforce, OCES supports the independence anddignity of older adults and individuals with disabilities by providingessential information and services that promote healthy, safe livingwhich positively impacts our community. We are seeking a Revenue CycleAnalyst to ensure the transactional integrity and precision of theorganization\'s revenue streams by executing advanced claims analysis,resolving complex billing discrepancies, and optimizing private pay andmanaged care payment captures. What you\'ll do: Steward the granularvalidation, coding accuracy, and submission lifecycle of complex billingstreams to ensure technical compliance. Execute forensic, deep-diveaudits of unpaid, partial, or rejected claims to isolate technicalerrors, coordinating immediate corrective action to capture lostrevenue. Manage technical dispute resolution by functioning as theprimary operational link between Senior Care Options (SCO) and One Careplans (OCP), and internal stakeholders. Optimize the mechanisms fortracking, invoicing, and capturing SCO and OCP fee balances, mitigatingbad-debt risk through systematic and empathetic follow-up Continuouslyaudit electronic data interchange (EDI) logs and member demographicflows to proactively eliminate recursive matching errors between billingnetworks Other duties as needed. Key Performance Indicators: KPI:Percentage of claims successfully passed and adjudicated on the initialsubmission pass. KPI: Average number of business days taken tosuccessfully resolve a flagged claim discrepancy or dispute. KPI: DaysSales Outstanding (DSO) minimization across SCO and OCP. What you\'llbring: Strong analytical and critical thinking skills ExcellentOrganizational Skills And Attention To Detail Experience With Federaland state contracts Proficient with Microsoft 365 and related software Aminimum of Five years of experience What you\'ll get: The ability towork with an enthusiastic team of like-minded individuals. Opportunityto develop professionally in your chosen career. Great work/lifebalance: 35-hour work week with some flexibility; standard M-F workweek; hybrid work environment