Full-Time Revenue Cycle Analyst

Reporting to the Revenue Integrity Manager, the Revenue Cycle Analyst plays a vital role in supporting both medical and pharmacy revenue operations by analyzing billing performance, monitoring KPIs, identifying trends in payer behavior, and producing actionable insights that drive operational improvements.

• Track key revenue cycle metrics including AR days, clean claim rate, denial rate, payment lag, and net collection rate.
• Monitor payer mix, reimbursement trends, and denial volumes to identify systemic issues or inefficiencies.
• Evaluate trends in medical and pharmacy billing and proactively recommend solutions to increase collections and reduce payment delays.
• Develop actionable insights and strategies to support revenue cycle improvements across departments.
• Support the creation of appeals, workflows, and edits based on recurring denials or underpayments.

• Build and maintain real-time dashboards using tools like Power BI, Tableau, and Epic Reporting Workbench.
• Generate monthly, quarterly, and ad hoc reports to guide leadership decision-making.
• Present root cause analyses and financial trends in concise, visual formats tailored to varied stakeholders.
• Identify key drivers of variance in expected vs. actual reimbursements and contribute to forecasting models.

• Analyze operational bottlenecks in charge entry, coding, claim submission, and denial workflows.
• Model performance outcomes and conduct what-if analyses to project financial impact of process changes.
• Provide insight into payer-specific behaviors and reimbursement policies that impact cash flow and AR aging.
• Participate in payer meetings and revenue cycle vendor check-ins to represent data findings and accountability measures.

• Utilize Epic EHR and pharmacy billing platforms (e.g., ComputerRx) to extract, validate, and analyze billing data.
• Ensure compliance with billing standards, HIPAA regulations, and payer-specific requirements.
• Contribute to chargemaster reviews and documentation audits with insight into revenue impact.

• 1–3 years of experience in revenue cycle analytics, revenue integrity, or healthcare billing and reporting roles.
• Hands-on experience with Epic (preferably Clarity or Reporting Workbench) and pharmacy billing systems.
• Familiarity with healthcare billing standards (i.e., CPT, HCPCS, ICD-10), payer reimbursement methodologies, denial management, and claims processing in either ambulatory, pharmacy, or FQHC settings.

• Associate degree in Business, Healthcare Administration, Informatics, Finance, or related field.
• Certified Revenue Cycle Representative (CRCR) or equivalent revenue cycle certification.
• Understanding of FQHC-specific revenue cycle nuances and value-based care reimbursement.
• Wizard level Excel skills

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