Remote Revenue Cycle Analytics & Operations Analyst

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

Benefits offered by this job

Paid vacation days

Sick leave

Paid holidays

Medical, dental, and vision insurance

Job summary

Clarvida is seeking a Revenue Cycle Operations Analyst in California (Remote/Hybrid) to optimize front-end revenue cycle performance across multiple programs. You will serve as a subject matter expert in eligibility verification, payer requirements, and billing readiness, collaborating with clinical and revenue cycle leadership to drive data-driven improvements.

Responsibilities include analyzing workflows, developing KPIs and dashboards, and delivering training on payer requirements.

Qualifications

• Bachelor's degree required or equivalent experience in healthcare operations or analytics.
• 3+ years of revenue cycle, billing operations, financial clearance, or related analytical experience.
• Experience interpreting Medi-Cal, Medi-Medi, commercial payer, eligibility, authorization, Share of Cost, and claim readiness requirements.
• Experience analyzing operational data and developing reports, dashboards, and performance metrics.
• Proficiency in Microsoft Excel and reporting tools.

Responsibilities

• Analyze front-end revenue cycle workflows, eligibility verification, financial clearance, and billing readiness across programs.
• Interpret Medi-Cal, Medi-Medi, commercial payer requirements and provide operational guidance.
• Develop and maintain revenue cycle procedures, controls, and best practices for compliant operations.
• Prioritize issues, identify risks, and coordinate corrective actions with leadership.
• Review billing errors and trends to identify root causes and improvement opportunities.

Education

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, Analytics, Public Health, or a related field

Tools

IRIS

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Job description

Clarvida is seeking a Revenue Cycle Operations Analyst in California (Remote/Hybrid) to optimize front-end revenue cycle performance across multiple programs. You will serve as a subject matter expert in eligibility verification, payer requirements, and billing readiness, collaborating with clinical and revenue cycle leadership to drive data-driven improvements.

Responsibilities include analyzing workflows, developing KPIs and dashboards, and delivering training on payer requirements.