Overview

As the Revenue Cycle Analyst, you will play an essential role in analyzing, driving and improving revenue cycle operations for Primary Care by coordinating with outsourced Revenue Cycle Management (RCM) vendor(s) to ensure timely follow-up and resolution of unpaid, incorrectly paid, and denied medical claims.

This role focuses on monitoring and evaluating vendor performance, supporting issue resolution, and ensuring compliance with established processes and payer requirements. It plays a key role in achieving revenue cycle performance objectives, including cash collections, denial management, bad debt reduction, and days sales outstanding.

The salary range for this position is $80,000 - $85,000 per year.

This role is in person at least 3 days per week (5 days during the training period) at our Framingham, MA office. We are conveniently located off Route 9 in Framingham, MA, close to routes 90 and 495 in a spacious modern office with a workout center available right in the building!

What's in it for you: PPO Medical, Dental, and Vision Insurance, 401(k) + Company match, Paid Time Off, hybrid schedule opportunity, monthly meal program, Verizon Wireless, Dell, and other employee discounts, profit sharing, and employee referral bonuses.

Responsibilities

Data Analysis and Insights

• 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).

Vendor Liaison

• 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.

Problem Solving and Root Cause Analysis

• Conduct root cause analysis on recurring issues (denials, underpayments, delays) and propose solutions.
• Identify upstream operational issues impacting billing (documentation, eligibility, coding).

Process Improvement

• Identify opportunities to improve workflows, reporting, and vendor processes.
• Support or lead small-scale process improvement initiatives.

Qualifications

Skills & Specifications:

• 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.

Education & Qualifications:

• 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.