Revenue Cycle Operations Analyst

Clarvida - California • Garden Grove, CA

43d • $85,000 - $95,000 • Hybrid

About The Position

The Revenue Cycle Operations Analyst supports California Operations by analyzing and improving front-end revenue cycle performance across multiple programs. This role serves as a subject matter expert in eligibility verification, payer requirements, authorization management, financial clearance, and billing readiness processes. Working closely with operational, clinical, and revenue cycle leadership, the Revenue Cycle Operations Analyst identifies opportunities for process improvement, reduces billing and compliance risks, and supports organizational performance through data-driven decision-making and operational excellence.

Requirements

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, Analytics, Public Health, or a related field, or an equivalent combination of education and directly related experience
• Minimum three years of revenue cycle, billing operations, financial clearance, healthcare operations, payer operations, or related analytical experience
• Experience interpreting Medi-Cal, Medi-Medi, commercial payer, eligibility, authorization, Share of Cost, and claim readiness requirements
• Experience analyzing operational data and developing reports, dashboards, and performance metrics
• Experience with EHR and billing platforms such as IRIS, Avatar, or similar systems
• Advanced proficiency in Microsoft Excel and reporting tools
• Strong analytical, critical thinking, and problem-solving skills
• Ability to exercise independent judgment and make recommendations regarding complex operational issues

Nice To Haves

• Experience supporting multiple programs, regions, or business units
• Experience with healthcare KPI reporting, dashboard development, business intelligence, or data visualization tools
• Knowledge of County behavioral health systems, public behavioral health funding structures, and payer contracts
• Experience leading process improvement initiatives, workflow redesign, or cross-functional projects
• CRCR, CHAA, HFMA, Lean Six Sigma, or related certification preferred

Responsibilities

• Analyze front-end revenue cycle workflows, eligibility verification processes, financial clearance activities, and billing readiness across multiple programs
• Interpret Medi-Cal, Medi-Medi, commercial payer, authorization, Share of Cost, and eligibility requirements and provide operational guidance
• Develop, implement, and maintain revenue cycle procedures, controls, and best practices that support compliant and efficient operations
• Prioritize revenue cycle issues, identify risks, and coordinate corrective actions with operational and revenue cycle leadership
• Review billing errors, financial clearance trends, and workflow exceptions to identify root causes and improvement opportunities
• Recommend and monitor corrective action plans to improve claim readiness and reduce denial risks
• Develop and maintain key performance indicators (KPIs), dashboards, scorecards, and operational reports
• Analyze operational and financial data to identify trends, forecast risks, and support performance improvement initiatives
• Present findings, recommendations, and action plans to leadership and stakeholders
• Design and deliver training related to payer requirements, eligibility processes, financial clearance, and billing readiness standards
• Provide subject matter expertise on EHR and billing platforms, including IRIS, Avatar, or similar systems
• Collaborate with clinical, operational, billing, and leadership teams to improve workflows and support organizational goals
• Participate in county, operational, revenue cycle, and cross-functional meetings as needed
• Support contract compliance, reporting requirements, audits, and operational initiatives
• Perform additional duties as assigned

Benefits

• Paid vacation days (increase with tenure)
• Separate sick leave that rolls over annually
• Paid holidays
• Medical, dental, and vision insurance options
• DailyPay – access your earnings without waiting for payday
• Training, development, and professional growth opportunities
• 401(k)
• Employee Assistance Program (EAP)
• Pet insurance
• Perks @ Clarvida – national discounts on shopping, travel, Verizon, and entertainment

What This Job Offers

• Job Type: Full-time
• Career Level: Mid Level