Role: Revenue Cycle Analyst
Experience:10+ Years.
Location: CT, MA(Onsite).
Duration: Long Term-Contract.
Position Overview
We are seeking a non-clinical analyst within the Clinical Informatics Department to support revenue cycle operations through data analysis, reporting, and revenue cycle system support. This role will work closely with revenue cycle leadership, finance, and information technology personnel to analyze operational and financial data, develop reports, and identify opportunities to improve billing accuracy, reimbursement, and revenue cycle performance.
The Revenue Cycle Analyst contributes a financial and reporting lens to clinical informatics initiatives, including EHR implementation, optimization, and system governance. This position does not involve direct patient care or clinical decision-making responsibilities.
Within the Clinical Informatics Department, the Revenue Cycle Analyst supports the effective use of clinical and financial data to drive operational and financial performance. The role focuses on bridging clinical documentation and revenue cycle outcomes by leveraging informatics tools, reporting, and data analysis.
The analyst collaborates with clinical informatics staff to:
● Align revenue cycle reporting needs with EHR design and optimization efforts.
● Support data governance, data definitions, and reporting standards across clinical and financial domains.
● Identify opportunities where informatics-driven improvements can enhance billing accuracy, reimbursement, and revenue integrity.
This role strengthens the Clinical Informatics Department''s ability to deliver integrated clinical and financial insights that support organizational sustainability. This role will support the design, build, and configuration of revenue cycle-related components within the EHR.
Key Responsibilities Include
● Develop and maintain operational and financial reports related to revenue cycle performance, including billing activity, claims submission, reimbursements, denials, and collections.
● Analyze revenue cycle data to identify trends, operational inefficiencies, and propose opportunities to improve billing accuracy, reimbursement, and financial performance.
● Support revenue cycle reporting and financial reconciliation activities during EHR system implementation, including participation in revenue cycle-related system build, configuration, and validation, and post-implementation optimization.
● Collaborate with clinical informatics, revenue cycle leadership, finance staff, and information technology personnel to define reporting requirements and revenue cycle-related system build needs, and develop dashboards or reporting tools to support operational decision-making.
● Support system testing, upgrades, and implementation activities related to revenue cycle systems and reporting tools, including participation in integrated testing, workflow validation, and issue resolution for revenue cycle-related EHR functionality.
● Participate in the build, configuration, and maintenance of revenue cycle-related EHR components (e.g., billing workflows, charge capture support, revenue cycle reporting objects), under Clinical Informatics governance and change management processes.
● Document reporting processes, data definitions, and maintain compliance with state and federal reporting requirements.
● Monitor and report on core revenue cycle KPIs (e.g., net collection rate, clean claim rate, days in A/R, denial rate, cost to collect, discharged-not-final-billed) and flag adverse trends to leadership.
● Support accounts receivable (A/R) follow-up by analyzing aging buckets and identifying aged or high-risk accounts requiring escalation.
● Participate in denial management and appeals workflows, performing root-cause analysis on denial trends and coordinating corrective action with coding, clinical, and payer-facing staff.
● Review charge capture processes and the Charge Description Master (CDM) to help ensure charges are complete, accurate, and compliant.
Analyze payer contract terms and fee schedules to validate expected reimbursement and identify underpayment or variance trends.
● Support patient financial services functions, including self-pay/patient-balance reporting, statement accuracy, and compliance with price transparency requirements (e.g., the No Surprises Act and hospital price transparency rule).
● Assist with responses to internal and external audits (e.g., payer audits, RAC audits) involving revenue cycle documentation and reporting.
● Monitor EDI transaction activity (837 claims, 835 remittance advice) for accuracy and completeness, and troubleshoot transmission issues with the clearinghouse.
Qualifications
Experience Requirements
● Associate or Bachelor''s degree in Healthcare Administration, Business Administration, Finance, Information Systems, or a related field, or an equivalent combination of education and relevant experience.
● Minimum of three (3) years supporting healthcare revenue cycle operations, financial systems, or healthcare reporting.
● Experience working with hospital revenue cycle systems or EHR platforms.
● Experience developing reports using healthcare reporting tools or business intelligence platforms.
● Knowledge of revenue cycle processes including billing, claims processing, reimbursement, and collections.
● Experience with authorizations, management of pre-authorizations and eligibility verifications.
● Payor management and building payor relationships.
● Demonstrated experience with managing clearinghouse relationships and processes.
● Knowledge of payer reimbursement methodologies, denial management, and revenue cycle performance metrics.
● Ability to analyze operational data and communicate findings to both technical and non-technical stakeholders.
● Familiarity with medical coding structures (ICD-10-CM/PCS, CPT, HCPCS) and their downstream impact on charge accuracy and reimbursement.
● Experience with accounts receivable (A/R) management, denial/appeals workflows, and revenue cycle KPI reporting (e.g., DNFB, net collection rate, clean claim rate, days in A/R).
● Understanding of payer contract terms, fee schedules, and underpayment identification/recovery processes.
● Familiarity with patient financial services operations and regulatory requirements such as price transparency rules and the No Surprises Act.
Additional Skills and Requirements
● Experience supporting or participating in EHR build, configuration, or optimization activities related to revenue cycle workflows, reporting, or billing functions.
● Knowledge of healthcare reporting tools and data analysis techniques.
● Ability to analyze large data sets and develop actionable insights.
● Ability to communicate technical information to operational stakeholders.
● Ability to participate in occasional on-site meetings at hospital locations as needed to support EHR implementation and optimization activities.
● Working knowledge of EDI transaction sets (837/835) and experience troubleshooting clearinghouse transmission issues.
● Familiarity with process-improvement methodologies (e.g., Lean, Six Sigma) as applied to revenue cycle workflows.
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