Position Objective:
The Revenue Cycle Analyst is responsible for evaluating and optimizing the financial, operational, and administrative processes for Better Health Group. This role involves analyzing data, identifying inefficiencies, and implementing strategies to improve revenue collection, reduce claim denials, and ensure accurate billing and coding practices.
Responsibilities:
- Analyzes revenue cycle performance metrics, including accounts receivable, denial rates, collection trends, and payer performance
- Develops and maintains dashboards and reports to monitor revenue cycle KPIs
- Identifies root causes of revenue leakage and recommends actionable solutions
- Reviews and improves processes related to patient registration, insurance verification, billing, coding, and collections
- Conducts audits of billing and coding practices to ensure accuracy and compliance with regulations
- Collaborates with cross-functional teams to streamline workflows and improve cash flow
- Monitors the status of submitted claims to ensure timely processing and payment
- Investigates and resolves claim denials, rejections, and underpayments
- Works with Payers to address discrepancies and escalate unresolved issues
- Ensures adherence to federal, state, and payer-specific regulations, including HIPAA, ICD-10, CPT, and HCPCS guidelines
- Conducts regular compliance reviews and implements corrective actions as needed
- Utilizes revenue cycle management tools and software to extract data and generate insights
- Works with IT teams to address system issues, implement enhancements, and ensure accurate data integration
- Provides training to colleagues on the effective use of revenue cycle technologies
- Partners with clinical, financial, and operational teams to address revenue cycle challenges and opportunities
- Prepares and presents findings, trends, and recommendations to leadership
- Acts as a point of contact for revenue cycle-related questions and concerns
- Additional duties as assigned
Position Requirements/ Skills:
- Bachelor’s Degree in Healthcare Administration, Business, Finance, or a related field preferred
- 2+ years of experience in revenue cycle management, healthcare analytics, or a related role
- Familiar with EMR/EHR software, eCW preferred
- Proficiency in data analysis tools (e.g., Excel, SQL, Tableau, Power BI)
- Proficient with Google Suite (Drive, Gmail, Docs, Sheets, Slides) for real-time collaboration
- In-depth knowledge of billing, coding, and claims processes in a healthcare setting
- Understanding of healthcare regulations and compliance requirements
- Strong analytical and problem-solving skills
- Excellent organizational, time-management, and multi-tasking skills with strong attention to detail
- Demonstrated ability to handle data with confidentiality
- Ability to work cross-functionally with multiple teams and independently with minimal supervision
- Excellent written and verbal communication skills; must be comfortable communicating with external/internal stakeholders, providers, and health plans
- Strong interpersonal and presentation skills
- Must be results-oriented with a focus on quality execution and delivery
- Appreciation of cultural diversity and sensitivity toward target patient populations
Physical Requirements:
- Physical ability to sit, stand, and move freely about the office
- Must be able to remain in a stationary position up to or exceeding 50%
- Ability to stand, walk, and sit for long periods of time; ability to climb stairs
- Ability to bend, stoop, kneel, squat, twist, reach, and pull
- Constantly operates a computer and other office productivity machinery, such as copy machine, and computer printer
- Ability to sit for extended periods of time
Key Attributes/ Skills:
- Has a contagious and positive work ethic, inspires others, and models the behaviors of core values and guiding principles
- An effective team player who contributes valuable ideas and feedback and can be counted on to meet commitments
- Is able to work within the Better Health environment by facing tasks and challenges with energy and passion
- Pursues activities with focus and drive, defines work in terms of success, and can be counted on to complete goals
Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties, or responsibilities required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.