REVENUE CYCLE SYSTEMS ANALYST

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Job Summary

The Revenue Cycle Systems Analyst supports Revenue Cycle operations by implementing billing system enhancements, maintaining revenue integrity, and ensuring compliant billing practices across the organization. This role serves as a liaison between Revenue Cycle Operations, Information Technology, and other stakeholders to identify, analyze, and resolve charging, coding, billing, and denial-related issues. The Analyst conducts root cause analysis, develops recommendations, and collaborates with operational and technical teams to implement Epic system build changes and workflow improvements that optimize revenue cycle performance.

Essential Duties and Responsibilities

• Support the implementation, testing, and maintenance of Epic billing system updates and enhancements.
• Perform root cause analysis of charging, coding, billing, claim edits, denials, and reimbursement issues.
• Collaborate with Revenue Cycle Operations, Patient Financial Services, Health Information Management, Compliance, Clinical Departments, and IT teams to identify and resolve system-related issues.
• Analyze revenue cycle workflows and recommend process improvements to enhance operational efficiency and billing accuracy.
• Work with Epic analysts and technical teams to design, test, validate, and implement system build modifications.
• Monitor billing system performance and proactively identify issues impacting revenue capture, reimbursement, or regulatory compliance.
• Investigate claim denials and payment variances to identify trends and recommend corrective actions.
• Develop and execute test plans for system enhancements, upgrades, and regulatory changes.
• Validate system functionality following implementation of updates or corrective actions.
• Assist in maintaining revenue cycle policies, procedures, and documentation related to system workflows and billing processes.
• Produce reports and data analysis to support operational decision-making and revenue cycle initiatives.
• Participate in projects related to regulatory requirements, payer changes, workflow optimization, and revenue integrity programs.
• Provide end-user support, troubleshooting, and training related to revenue cycle systems and workflows.
• Ensure compliance with federal, state, payer, and organizational billing regulations and standards.

Qualifications

Education

• Bachelor's degree in Healthcare Administration, Health Informatics, Information Systems, Business Administration, Finance, or a related field required.
• Equivalent combination of education and relevant experience may be considered.

Experience

• Minimum of three (3) to five (5) years of experience in Revenue Cycle, Healthcare Information Systems, Patient Financial Services, Revenue Integrity, or related healthcare operations required.
• Experience supporting Epic Revenue Cycle applications strongly preferred.
• Experience with hospital and physician billing workflows preferred.
• Experience performing data analysis, system testing, and process improvement initiatives preferred.

Knowledge, Skills, and Abilities

• Strong understanding of healthcare revenue cycle processes, including registration, charge capture, coding, claims processing, reimbursement, denials management, and collections.
• Knowledge of healthcare billing regulations and payer requirements.
• Familiarity with Epic Resolute Professional Billing (PB), Hospital Billing (HB), Claims, Charge Router, or related Epic modules preferred.
• Strong analytical and problem-solving skills with the ability to conduct root cause analysis and identify effective solutions.
• Ability to interpret billing, reimbursement, and financial data.
• Proficiency with Microsoft Excel, reporting tools, and data analysis techniques.
• Excellent communication and interpersonal skills with the ability to interact effectively with operational and technical teams.
• Strong organizational skills and ability to manage multiple priorities in a fast-paced environment.
• Ability to work independently and collaboratively on cross-functional projects.

Preferred Certifications

• Epic Certification in Resolute Professional Billing (PB), Hospital Billing (HB), Claims, or Revenue Cycle applications preferred.
• Certified Revenue Cycle Representative (CRCR) or related healthcare revenue cycle certification preferred.

Salary $75-100K