Revenue Cycle Management (RCM) Analyst
18 days ago
Los Angeles
Job DescriptionDescription: OUR MISSION Wellness Equity Alliance (WEA) is a novel national public health organization comprised of a multidisciplinary team of population and public health experts with backgrounds in infectious disease, public health, emergency medicine, primary care, cardiology, pediatrics, psychiatry, community health work (CHW), nursing and advanced practice pharmacy. We work nearly exclusively with underrepresented communities, fundamentally addressing health-care disparities and the social determinants of health (SDoH) that have been amplified during the COVID-19 pandemic, prioritizing the following: • People experiencing homelessness, • Indigenous communities, • Immigrant communities, • Rural communities, • BIPoC communities, • LGBTQIA+ communities Purpose of 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. Key Responsibilities Data Analysis & Reporting • 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. Claims & Denial Management • 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.Process Improvement, • 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.Compliance & Quality Assurance, • 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.Workflow Coordination & Collaboration, • 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.Essential Skills and Qualifications, • 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., • Work Arrangement: Remote, hybrid, or in-office, depending on organizational needs., • Industry Focus: Healthcare organizations including clinics, hospitals, and community-based care programs.Requirements:Qualifications and Education Requirements, • 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 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.