Remote Revenue Cycle Analyst: Eligibility & Billing Optimization

Pathways; Tustin (CA); Hybrid; USD 85,000 - 95,000; Full time

Benefits offered by this job

Paid vacation days

DailyPay earnings access

Medical, dental, vision insurance

Job summary

Clarvida is seeking a Revenue Cycle Operations Analyst to support California Operations, focusing on eligibility verification, billing readiness, and financial clearance across programs. You will help reduce billing risks and drive data-driven decision-making with leadership.

The role requires 3+ years in revenue cycle or related analytics, Excel proficiency, and experience with EHR platforms such as IRIS and Avatar. This is a full-time hybrid position in California with travel up to 30%.

Qualifications

• Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, Analytics, Public Health, or related field
• Minimum three years of revenue cycle, billing operations, or related analytical experience.
• Experience interpreting Medi-Cal, Medi-Medi, commercial payer, eligibility, authorization, Share of Cost, and claim readiness requirements
• Advanced proficiency in Microsoft Excel and reporting tools
• Experience with EHR and billing platforms such as IRIS, Avatar, or similar systems
• Strong analytical, critical thinking, and problem-solving skills
• Ability to exercise independent judgment and make recommendations regarding complex operational issues

Responsibilities

• Analyze front-end revenue cycle workflows, eligibility verification processes, financial clearance activities, and billing readiness across multiple programs
• Interpret Medi-Cal, Medi-Medi, commercial payer, authorization, Share of Cost, and eligibility requirements and provide operational guidance
• Develop, implement, and maintain revenue cycle procedures, controls, and best practices that support compliant and efficient operations
• Prioritize revenue cycle issues, identify risks, and coordinate corrective actions with operational and revenue cycle leadership
• Review billing errors, financial clearance trends, and workflow exceptions to identify root causes and improvement opportunities
• Recommend and monitor corrective action plans to improve claim readiness and reduce denial risks
• Develop and maintain KPIs, dashboards, scorecards, and operational reports
• Analyze operational and financial data to identify trends, forecast risks, and support performance improvement initiatives
• Present findings, recommendations, and action plans to leadership and stakeholders
• Design and deliver training related to payer requirements, eligibility processes, financial clearance, and billing readiness standards
• Provide subject matter expertise on EHR and billing platforms, including IRIS, Avatar, or similar systems
• Collaborate with clinical, operational, billing, and leadership teams to improve workflows and support organizational goals
• Participate in county, operational, revenue cycle, and cross-functional meetings as needed
• Support contract compliance, reporting requirements, audits, and operational initiatives
• Perform additional duties as assigned

Skills

Excel proficiency

Analytics & problem solving

Independent judgment

Medi-Cal/Med i-Medi knowledge

Interpreting payer requirements

Education

Bachelor's degree in Healthcare Administration or related field

Tools

IRIS

Avatar

Job description

Clarvida is seeking a Revenue Cycle Operations Analyst to support California Operations, focusing on eligibility verification, billing readiness, and financial clearance across programs. You will help reduce billing risks and drive data-driven decision-making with leadership.

The role requires 3+ years in revenue cycle or related analytics, Excel proficiency, and experience with EHR platforms such as IRIS and Avatar. This is a full-time hybrid position in California with travel up to 30%.