Revenue Cycle Analytics Specialist

Emerus Holdings, Inc.; The Woodlands (TX); On-site; USD 70,000 - 100,000; Full time

Job summary

Emerus Holdings, Inc. in The Woodlands, TX, seeks a Revenue Cycle Analyst to join the centralized billing office. You will perform data‑driven analyses, ensure billing accuracy, and support performance improvement across revenue cycle operations.

The role collaborates with subject matter experts, creates dashboards, and delivers ad hoc reports to stakeholders. Candidates should have 3+ years in revenue cycle analytics, strong Excel and BI skills, and knowledge of payer contracts and EOBs.

Qualifications

• 3+ years of related analyst experience with a preference for revenue cycle, hospital billing, and third‑party payer reimbursement.
• Advanced skills in using Excel and BI data applications to maneuver through large volumes of data, required.
• Experience with inpatient and outpatient billing requirements (UB-04), required.
• Proficiency in health insurance billing, collections, and eligibility as it pertains to commercial, managed care, government, and self‑pay reimbursement concepts and overall operational impact.
• Knowledge of third‑party payer reimbursement methodologies/contracts and CMS Medicare; Texas state Medicaid reimbursement a plus.

Responsibilities

• Runs, reviews, interprets, analyzes, and validates large, complex datasets from various health information sources (e.g., claims, contracts, operational data).
• Analyzes reimbursement by utilizing knowledge of group payer contracts, payer policies, member benefits, and comparing actual to expected reimbursement.
• Reviews, analyzes, interprets, and reconciles EOBs and payer remittances to identify denial trends and reduce controllable rejections.
• Analyzes data trends, conducts root cause analysis, and performs denials analysis to identify solutions and reduce rejections.
• Gathers and analyzes revenue cycle data to provide ad hoc information to internal and external stakeholders.
• Ensures data integrity across the revenue cycle and organization to support decision-making and actionable insights.
• Applies knowledge of hospital billing, medical coding, and contractual terms to analyze claim denials and communicate insurance policy changes to stakeholders.
• Updates and maintains fee schedules and reimbursement models for Medicare and commercial insurance payers.
• Conducts revenue cycle analysis and provides trends as needed by Revenue Cycle leadership team to identify improvement opportunities.
• Contributes to internal initiatives and projects related to Revenue Cycle data, analytics, and reporting.
• Performs data extraction and manipulation using BI tools, Excel, and other query tools within practice management systems.
• Has detailed knowledge of core Revenue Cycle systems and all bolt‑on software solutions.
• Assist in creating and monitoring models that connect strategies to measures of performance that ensure successful reporting of revenue cycle data. Collaborate with various IT departments, Reporting teams, Revenue Recognition, and Managed Care to develop dashboards and metrics tracking.
• Independently performs complex research, compiles financial analyses, and develops detailed spreadsheets; prepares in‑depth analyses focused on accuracy, reliability, and timeliness; provides/presents interpretation of findings to revenue cycle leaders.
• Develops analyses and reports to support key initiatives, including identification and recommendation of improvements to existing processes, with timely follow-through as appropriate.

Skills

Excel

BI data

Data analysis

Problem solving

Independent worker

Education

Bachelor’s degree

Tools

BI tools

Query tools

Practice management systems

Job description

Emerus Holdings, Inc. in The Woodlands, TX, seeks a Revenue Cycle Analyst to join the centralized billing office. You will perform data‑driven analyses, ensure billing accuracy, and support performance improvement across revenue cycle operations.

The role collaborates with subject matter experts, creates dashboards, and delivers ad hoc reports to stakeholders. Candidates should have 3+ years in revenue cycle analytics, strong Excel and BI skills, and knowledge of payer contracts and EOBs.