Revenue Cycle Analyst - Primary Care

Responsibilities

• Analyze trends in denials, AR aging, and reimbursement to identify root causes and recommend corrective actions.
• Develop and maintain regular reporting on key revenue cycle KPIs (DSO, denial rates, cash collections).
• Evaluate RCM vendor performance against SLAs and KPIs and escalate gaps with recommended actions.
• Partner with RCM vendor to implement process improvements and track outcomes.
• Collaborate with the RCM vendor to clarify payer requirements, claim documentation needs, and resolution strategies.
• Support communication between internal departments and the RCM vendor to resolve data, eligibility, or documentation issues impacting claims.
• Conduct root cause analysis on recurring issues (denials, underpayments, delays) and propose solutions.
• Identify upstream operational issues impacting billing (documentation, eligibility, coding).
• Identify opportunities to improve workflows, reporting, and vendor processes.
• Support or lead small-scale process improvement initiatives.

Qualifications

• Strong analytical skills with ability to interpret complex data sets and translate into actionable insights.
• Experience working with revenue cycle KPIs and performance metrics.
• Ability to identify trends and identify opportunities to improve them.
• Strong organizational and follow-up skills with attention to detail.
• Effective problem-solving skills and ability to follow established workflows and escalation pathways.
• Strong written and verbal communication skills, including professional interaction with external vendors and internal stakeholders.
• Ability to manage multiple priorities in a deadline-driven environment.
• Working knowledge of healthcare billing, accounts receivable, denial resolution, and payer processes.
• Proficiency in Microsoft Office applications (Excel, Outlook, and Word).
• Ability to work independently while contributing to a collaborative, cross-functional environment.
• Associate’s Degree or equivalent combination of education and relevant work experience.
• 2–4 years of experience in healthcare revenue cycle, billing, accounts receivable, or vendor-supported RCM operations preferred.
• Working knowledge of Medicare, Medicaid, and third-party payer requirements and claims workflows.
• Experience working with or supporting an outsourced RCM vendor helpful.
• Experience in a multi-specialty physician practice or post-acute care setting preferred.

Pay

The salary range for this position is $80,000 - $90,000 per year.

Schedule

This role is in person at our Framingham, MA office. There is potential for 1-2 work-from-home days per week after the training period.