Revenue Cycle Management (RCM) Analyst
About The Position
The Revenue Cycle Management (RCM) Analyst plays a critical role in optimizing the financial performance of the organization by analyzing revenue cycle data, identifying trends, reducing claim denials, and supporting timely and accurate reimbursement. This role monitors the full revenue cycle—from patient registration through final payment—to improve cash flow, operational efficiency, and regulatory compliance. The RCM Analyst partners closely with billing, clinical, finance, and operational teams to identify issues, recommend improvements, and support data-driven decision-making across revenue cycle functions.
Requirements
- Strong analytical and problem-solving skills with high attention to detail.
- Ability to interpret complex data sets and translate findings into clear recommendations.
- Knowledge of medical billing and coding concepts (ICD-10, CPT, HCPCS).
- Proficiency in Microsoft Excel (pivot tables, formulas, data analysis).
- Experience working with Electronic Health Record (EHR) and billing systems (e.g., Epic, Athena, NextGen, Cerner, or similar).
- Strong written and verbal communication skills.
- Ability to work independently while collaborating across teams.
- Industry Focus: Healthcare organizations including clinics, hospitals, and community-based care programs.
- Bachelor’s degree in Business, Finance, Health Administration, Information Systems, or a related field (preferred).
- Minimum of 3+ years of experience in healthcare billing, revenue cycle, finance, or health information systems.
- Experience supporting hospital, clinic, or multi-site healthcare operations strongly preferred.
Nice To Haves
- Experience with revenue cycle analytics, reporting tools, or business intelligence platforms.
- Familiarity with payer contracts, reimbursement methodologies, and value-based care models.
- Experience working in multi-site or multi-state healthcare organizations.
- Certification in medical billing, coding, or revenue cycle management (e.g., CPB, CPC, CRCR) is a plus.
Responsibilities
- Analyze billing, claims, and payment data to identify trends, risks, and opportunities for revenue optimization.
- Develop and maintain reports and dashboards to track key revenue cycle performance indicators (e.g., denial rates, days in A/R, clean claim rates).
- Provide actionable insights and recommendations to revenue cycle leadership and cross-functional teams.
- Review, audit, and analyze denied or rejected insurance claims to identify root causes.
- Partner with billing teams to correct errors, resubmit claims, and prevent recurring issues.
- Track denial trends and support strategies to reduce future denials.
- Identify workflow inefficiencies or bottlenecks across front-end and back-end revenue cycle processes.
- Support the development and implementation of process improvements to enhance efficiency, accuracy, and reimbursement timelines.
- Assist with documentation of workflows, policies, and standard operating procedures.
- Ensure adherence to HIPAA, CMS, payer-specific requirements, and other applicable regulations.
- Support internal audits and compliance reviews related to billing and revenue cycle operations.
- Monitor data accuracy and integrity across revenue cycle systems.
- Collaborate with front-end teams (registration, eligibility, authorization) and back-end teams (billing, coding, collections).
- Serve as a liaison between departments to resolve revenue-impacting issues.
- Support training efforts by sharing insights and best practices related to revenue cycle performance.
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What This Job Offers
Job Type
Full-time
Career Level
Mid Level
