Senior Revenue Cycle Operations Analyst

Responsibilities

• Oversee the end-to-end accounts receivable process, including claim follow-up, status inquiries, and comprehensive management of rejections, denials, and corrected claims.
• Serve as the primary interface for external partners, leading difficult conversations regarding account discrepancies and financial disputes with diplomacy and professional resilience.
• Reconcile customer accounts, payment applications, and offsets across NetSuite and billing systems (Candid), ensuring 100% transactional accuracy and immediate resolution of balancing variances.
• Enforce rigorous sub-ledger data standards and proactively isolate high-impact downstream data risks to prevent operational bottlenecks.
• Navigate ambiguity by diagnosing billing discrepancies and compiling clear, actionable summaries for leadership, operating effectively without reliance on step-by-step guidance.
• Analyze payer-specific reimbursement trends to identify and report critically on payment issues, underpayments, and systemic errors.
• Convert complex medical billing, denial, and reimbursement issues into clear, actionable insights for non-billing stakeholders to ensure strategic alignment.
• Manage a demanding, fast-paced workload with independent prioritization, ensuring strict adherence to daily posting activities and critical month-end deadlines.
• Act as a subject matter expert, refining internal billing guidelines and establishing new processes where gaps exist to drive continuous improvement in revenue cycle performance.
• Maintain credit balances for timely refunds and propose write-offs or bad debt adjustments in strict accordance with payer policies.
• Facilitate technical setup calls with new health plans and partners to align on billing expectations, establish operational workflows, and ensure launch readiness.
• Validate invoicing and claims integrations prior to launch to guarantee error-free submission and timely payment processing.
• Proactively prevent and resolve payment blockers by identifying potential billing bottlenecks during onboarding and coordinating directly with payer contacts to establish clear resolution pathways before issues arise.

Qualifications

• Revenue Cycle Expertise: 5+ years of experience in healthcare revenue cycle management, with comprehensive knowledge of commercial and government payer policies, CPT/HCPCS/ICD-10 coding, and EOB reconciliation.
• Billing Operations: Proficiency in B2B and patient billing/collections, paired with technical literacy in MS Office and Google Workspace.
• Operational Autonomy: Proven track record of managing high-velocity, complex workloads independently.
• Ability to navigate ambiguity and create processes from scratch without reliance on existing SOPs.
• Strategic Communication: Exceptional ability to lead high-stakes, external partner meetings and translate complex billing issues into clear insights for non-billing stakeholders.
• Execution & Accuracy: Demonstrated success in prioritizing competing deadlines while maintaining 100% data accuracy and high execution velocity.
• Excellent problem-solving skills with the ability to manage multiple priorities completely independently without sacrificing accuracy or execution velocity.
• Proven track record of managing a heavy workload and tight deadlines independently, with a high degree of comfort in ambiguity and a demonstrated ability to create processes where none exist.

Preferred Qualifications

• Background in high-growth healthcare startups, with experience coordinating data-driven reconciliation or onboarding projects.
• Hands-on experience executing complex, cross-system ledger reconciliations using platforms such as NetSuite, LightDash, and standard Revenue Cycle platforms.
• Direct experience executing and troubleshooting cash application, payment posting, and cross-system ledger reconciliation workflows, with hands-on proficiency navigating NetSuite databases for data integrity and sub-ledger matching alongside LightDash and standard Revenue Cycle platforms.
• Background in managing data-driven reconciliation or onboarding projects.