The Revenue Cycle & Financial Analyst is responsible for auditing and optimizing the financial workflows of the healthcare organization. This role performs deep-dive analysis into patient billing accuracy, payroll efficiency, and operational expenses to identify cost-saving opportunities and revenue "leakage". You will serve as a bridge between the clinical, billing, and HR teams to ensure all transactions are accurate, compliant, and optimized for maximum cash flow.
- Audit Claims:Review billing and coding for accuracy before submission to ensure compliance with payer rules (Medicare, Medicaid, Private Insurance).
- Denial Management:Investigate claim denials and underpayments to identify root causes and implement corrective actions.
- Performance Metrics:Track key performance indicators (KPIs) such as Days in Accounts Receivable (AR) and net collection rates.
2. Payroll & Labor Oversight
- Timesheet Reconciliation:Audit staff timesheets and attendance records against billable patient hours to ensure accuracy.
- Labor Efficiency:Analyze overtime trends and staffing ratios to optimize payroll expenditures.
- Compliance:Ensure all payroll transactions meet state and federal tax and labor regulations.
3. Expense & Operational Review
- Budget vs. Actuals:Compare monthly spending against operating plans and report on significant variances.
- Cost Savings:Identify opportunities for cost reduction in departmental spending and supply chain management.
- Vendor Audits:Review third-party vendor invoices and contracts to ensure accurate billing and pricing.
- Dashboards:Create and maintain financial dashboards for leadership to visualize revenue vs. expense trends.
- Forecasting:Prepare revenue and expense forecasts to assist with annual budgeting.
- Process Improvement:Recommend and implement software or workflow changes to automate manual billing and payroll tasks.
Required Qualifications
- Education:Bachelor’s degree in Finance, Healthcare Administration, Accounting, or a related field.
- Experience:2–5 years of experience in healthcare revenue cycle management or financial analysis.
- Technical Skills:Advanced proficiency in Microsoft Excel (pivot tables, VLOOKUPs) and familiarity with EHR/billing systems (e.g., Epic, NexGen, or QuickBooks).
- Knowledge:Deep understanding of healthcare billing codes (ICD-10, CPT) and payer reimbursement models.