RCM Operations Analyst
Posted on 3/21/2023
Modernizing Medicine

1,001-5,000 employees

United States
Experience Level
Desired Skills
Sales & Account Management
Operations & Logistics
  • South Florida Business Journal, Business of the Year 2022
  • BIG Awards for Business, Company of the Year 2021
  • Best in Biz Award (Silver), Fastest-Growing Company of the Year 2021
  • South Florida Business Journal, Best Places to Work 2021
  • Inc. Magazine Best Workplaces of 2020
  • 3 years of experience in an analytical or accounting role preferred
  • 3 years of experience in a healthcare business office or similar setting
  • Bachelor's degree from an accredited 4-year university (strongly preferred) or working knowledge in capturing, analyzing, and communicating measurement results within a healthcare environment
  • Understanding of database concepts and structures
  • Working experience in creating, maintaining and troubleshooting data and reports
  • Analyze organizational financial and operational data and displays strong analytical and reasoning skills
  • Experience working with customer support/client issue resolution management
  • Demonstrate a general understanding of claims processing and ability to complete root cause analysis
  • Demonstrate success in process improvement
  • Practices, models, and norms collaboration with the intent to increase communication and improve team outcomes
  • Certified Revenue Cycle Professional (CRCP) must be obtained within 6 months of position start date
  • LEAN Six Sigma Green Belt, must be obtained within 6 months of position start date
  • Working knowledge Business Intelligence reporting software (example: Crystal, Qlik) preferred
  • Expertise in medical billing, front-office, physician practice management, and healthcare business processes
  • Comprehensive understanding of the full revenue cycle process for claim submission, medical insurance policies, and ICD-10 and CPT coding guidelines
  • Advanced excel skills such as the ability to use formulas to analyze data, tables and formatting, pivot tables/charts and conditional formatting
  • Knowledge of Fee For Service, Capitation, Workers Compensation
  • Excellent time management skills in order to produce timely reporting
  • Identify opportunities to improve revenue and collection performance through analysis of charges, claim denials, payments, accounts receivable, and escalated client metrics
  • Monitor operational key performance indicators to identify the root cause of poor performing metrics and make recommendations for improvement
  • SME within PM, gPM, and necessary analytic tools not limited to Qlik Sense, Salesforce, TPS, & NHXS
  • Develop strategies to capture additional data for better insight into performance improvement opportunities
  • Assist management in developing meaningful reports and summaries that provide support to the RCM Client Success team
  • Leverage management reports identifying areas for operational improvements and efficiencies for clients throughout their RCM lifecycle
  • Generate standard and custom statistical and analytical reports as requested by RCM Leadership using the Patient Accounting Systems, Microsoft Excel, SQL, and/or Qlik
  • Extract datasets from PM, Qlik, and other applications as necessary
  • Completion of Ad Hoc report request as assigned by management
  • Conduct detailed research into data and performance changes as identified and requested
  • Perform initial and final quality control assessment of reports prior to distribution
  • Serve as a RCM Client Success point of contact for new report requests/modifications
  • Collaborates with the technology teams and consultants on the design of internal databases and data needs
  • Complete accuracy checks of existing reports
  • Provide support to the Client Success and Operational teams in analyzing our clients' data
  • Facilitate internal Client Success Denial Workgroup
  • Establishes complementary and collaborative relationships with appropriate stakeholders/committee members, and RCM Leadership
  • Identify and develop new client reporting, trending and performance feedback with benchmarking of success indicators
  • Develop and upkeep scorecard/report card for client transitions throughout Client Success lifecycle
  • Other duties as assigned