Pediatric Revenue Cycle Operations Analyst

TITLE:

Pediatric Revenue Cycle Operations Analyst

REPORTING RELATIONSHIP:

Senior Director, Finance and Payment Strategy

BASIC FUNCTION:

Lead and support the development and delivery of pediatric revenue cycle education programs and resources for physicians, practices, hospitals, and related healthcare organizations and professionals. Serve as a subject matter expert (SME) for AAP staff, members, and external partners on pediatric revenue cycle operations, coding, documentation, and payment across hospital and ambulatory care settings.

DUTIES AND RESPONSIBILITIES:

1. Lead the design, development, implementation, and evaluation of pediatric revenue cycle and coding education programs for physicians, coders, practice leaders, revenue cycle professionals, hospitals, and healthcare organizations.
2. Develop comprehensive educational curricula, learning pathways, training materials, toolkits, workshops, webinars, self-paced courses, and competency-based learning resources related to pediatric revenue cycle operations, coding, documentation, healthcare payment systems, and practice performance, in collaboration with AAP staff.
3. Assess educational needs, identify knowledge and performance gaps, and develop innovative learning solutions that support pediatric practices, hospitals, and pediatric subspecialty organizations in improving revenue cycle performance, coding accuracy, and payment outcomes.
4. Serve as a staff liaison to relevant AAP member groups supporting revenue cycle, coding, payment, and practice and health system operations needs.
5. Collaborate with internal and external stakeholders to create specialized educational offerings addressing revenue cycle management, coding, payment, and practice transformation challenges.
6. Adopt new technologies and tools to enhance the precision, efficiency, and reach of revenue cycle, coding, and payment guidance.
7. Support consulting and advisory engagements by providing expertise in revenue cycle operations, coding, documentation, payment methodologies, charge capture, denial prevention and management, operational workflows, and practice performance improvement.
8. Provide guidance to members utilizing coding and payment support services by researching issues and providing technical assistance.
9. Support the expansion of revenue cycle and coding education, publications, consulting services, and other initiatives that enhance member value and contribute to organizational and revenue growth, including the development of innovative and engaging learning solutions and resources.
10. Analyze coding, billing, denial, and payment trends to identify educational opportunities and develop targeted training programs and resources.
11. Perform other duties as assigned.

EDUCATION:

Bachelor's degree in business administration, public health, finance, or related field discipline or an equivalent combination of relevant education and work experience required. Certified Professional Coder required; relevant certification in Diagnosis-Related Group (DRG) coding, as well as certifications related to healthcare finance, revenue cycle, auditing, compliance, or clinical documentation improvement preferred.

EXPERIENCE:

At least three years' related experience in healthcare revenue cycle operations, coding, payment, documentation, healthcare finance, or related healthcare operations required. Experience developing and delivering educational programs, training, and presentations for healthcare professionals required, as well as working with pediatric practices, pediatric subspecialties, children's hospitals, or other pediatric healthcare organizations. Experience with both hospital-based/facility and ambulatory/professional billing environments as well as supporting charge capture improvement, denial management, coding quality initiatives, payment analysis, practice operations, or revenue cycle performance improvement efforts preferred.

ESSENTIAL SKILLS:

Advanced knowledge of pediatric revenue cycle operations, healthcare payment methodologies, Current Procedural Terminology (CPT), International Classification of Diseases, Tenth Revision, Clinical Modification (ICD-10-CM), Healthcare Common Procedure Coding System (HCPCS), and Diagnosis-Related Group (DRG) systems required. Knowledge of both hospital-based/facility and ambulatory/professional coding, billing, and payment environments, including the operational and financial considerations unique to pediatric healthcare settings preferred. Excellent verbal/written communication, presentation, facilitation, interpersonal, analytical, consulting, and critical thinking skills required, with the ability to analyze coding, billing, denial, payment, and operational performance trends and translate findings into practical educational resources, technical assistance, and performance improvement initiatives. Strong technical acumen essential, with proficiency in MS Office and virtual meeting platforms (e.g., Teams) and the ability to learn and apply new technologies including the use of AI; experience working with revenue cycle, billing, coding, and payment reporting systems and analytics tools, document collaboration platforms (e.g., SharePoint), and project management tools (e.g., SmartSheet) preferred. Some evening/weekend work and travel are required, as well as the ability to be flexible with work schedule to accommodate physicians' availability.

A reasonable estimate of the current base pay range for this position is $95,237.05 - $100,528.22.

Compensation decisions take into account a wide range of factors, including but not limited to relevant experience, skills, certifications, geographic location, business needs, and organizational policies. In addition to those factors, we believe in the importance of pay equity and consider internal equity of our current team members as a part of any final offer. Hiring at the maximum of the range would not be typical. We also offer a comprehensive benefits package which includes healthcare and retirement savings plans. Click to see all benefits offered: http://aap.org/BenefitsAtAAP. The AAP does not use artificial intelligence (AI) to make employment decisions. Hybrid work environment of 40% of work time in the office per month.

To learn more about the organization, see a full job description, and/or apply for the position, please visit https://www.aap.org/employment.