Full-Time Revenue Cycle Strategy Analyst

Role Summary The Revenue Strategy Analyst will support all revenue cycle functions, including Revenue Cycle Operations, Payor Relations, and Credentialing, to support Operations and Executive Leadership. The Revenue Strategy Analyst will be responsible for gathering and aggregating data across multiple data sets to provide operations and executive leadership comprehensive insight into the financial health of the end-to-end revenue cycle including fee optimization through payor mix analysis, payor fee comparisons, and market-driven UCR analysis.

Duties & Responsibilities

• Work with Sr. Director of Payor Relations to update market-driven UCR analysis for annual increase recommendations, create payor mix analyses and provide insights on optimizing payor mix to improve reimbursement rates and financial performance.
• Work with Operations and Revenue Cycle teams to audit EOBs to ensure reimbursements are paid according to the current payor fee schedule and contractual agreements.
• Create a streamlined and transparent credentialing process; support the Credentialing and Operations teams to ensure Providers are credentialed/recredential with payors, and CAQH participation, while monitoring the credentialing ticket system.
• Implement credentialing software for enterprise.
• Maintain all payor contracts and support the management of payor contracts in tandem w. Sr. Payor Relations Direction. This includes renegotiation dates, payor fee schedules, and UCR fee schedules.
• Independently design, build, and execute a comprehensive data model for all Payor Relations and Revenue Cycle functions; serve as the centralized gateway for all data requests with regards to Payor Relations and Revenue Cycle data.
• Create and design centralized workflow functions for a hybrid team which includes offshore and onshore vendor partners.
• Provide ad-hoc analysis including revenue trend analysis, payor trend analysis, revenue forecasting, proformas, and monitoring of specific key performance indicators.
• Ability to analyze data for anomalies, trends, and opportunities for improvement by workflow changes or technology; able to work and manipulate copious amounts of data on multiple technology platforms and provide results in a presentable format.

Other duties as assigned.

Bachelor’s degree Business Administration, Accounting or Finance. MBA preferred.

5-7 years working in healthcare revenue cycle, payor relations, or related field.

Excellent Excel, Power BI, and Microsoft Office Suite.

Excellent problem-solving and interpersonal skills.

Basic understanding of practice management software or electronic health records software.

Dental knowledge preferred.

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