Revenue Cycle Analyst – Front-End & Eligibility (Remote)

Clarvida; Pico Rivera (CA); Hybrid; USD 85,000 - 95,000; Full time

Benefits offered by this job

Paid vacation days

Sick leave

Paid holidays

Health insurance

DailyPay

Job summary

Clarvida is seeking a Revenue Cycle Operations Analyst to optimize front-end revenue cycle performance across programs in California, with remote/hybrid flexibility. You will serve as a subject matter expert on eligibility verification, payer requirements, and financial clearance, partnering with clinical, operational, and leadership teams to improve workflows and reduce risks.

The role emphasizes data-driven decision-making, KPI development, and training on billing readiness standards,

Qualifications

• Minimum three years of revenue cycle, billing operations, financial clearance, healthcare operations, payer operations, 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.
• Experience with EHR and billing platforms such as IRIS, Avatar, or similar systems.
• Advanced proficiency in Microsoft Excel and reporting tools.
• 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

Analytical thinking

Problem solving

Communication

Independent judgment

Team collaboration

Education

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

Tools

IRIS

Avatar

Excel

Job description

Clarvida is seeking a Revenue Cycle Operations Analyst to optimize front-end revenue cycle performance across programs in California, with remote/hybrid flexibility. You will serve as a subject matter expert on eligibility verification, payer requirements, and financial clearance, partnering with clinical, operational, and leadership teams to improve workflows and reduce risks.

The role emphasizes data-driven decision-making, KPI development, and training on billing readiness standards,