Revenue Cycle Operations Specialist - GI
Brown University Health
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Job summary
Brown University Health is seeking a Revenue Cycle Operations Specialist to serve as the primary operational lead for revenue cycle performance within clinical departments and ambulatory practices. You will partner with physicians, Finance, Coding, Revenue Integrity, and Patient Financial Services to optimize reimbursement and reduce leakage.
In this role you will monitor metrics, develop dashboards, address denial trends, and implement workflow improvements across Epic systems.
Qualifications
- Bachelor's degree in a healthcare/related field required.
- Minimum five years in healthcare revenue cycle or related operations; Epic experience preferred.
- Knowledge of CPT, ICD-10 and reimbursement principles; relevant certifications preferred.
Responsibilities
- Lead revenue cycle operations and monitor departmental performance.
- Collaborate with providers, Finance, Coding, and Patient Financial Services.
- Identify optimization opportunities and mitigate revenue leakage.
- Develop and present reports to leadership.
- Drive workflow improvements and system enhancements (Epic).
Skills
Education
Tools
Job description
The Revenue Cycle Operations Specialist serves as the primary operational lead and subject matter expert for revenue cycle performance within assigned clinical departments, service lines, and ambulatory practices. Reporting to operational leadership, this position partners closely with physicians, advanced practice providers, Finance, Coding, Revenue Integrity, Patient Financial Services, Managed Care, Compliance, Information Systems, and other stakeholders to optimize revenue cycle performance and support financial sustainability. The position is accountable for identifying opportunities to improve revenue capture, reduce denials, enhance reimbursement, strengthen operational workflows, and mitigate revenue leakage.
The Revenue Cycle Operations Specialist serves as the primary operational lead and subject matter expert for revenue cycle performance within assigned clinical departments, service lines, and ambulatory practices. Reporting to operational leadership, this position partners closely with physicians, advanced practice providers, Finance, Coding, Revenue Integrity, Patient Financial Services, Managed Care, Compliance, Information Systems, and other stakeholders to optimize revenue cycle performance and support financial sustainability. The position is accountable for identifying opportunities to improve revenue capture, reduce denials, enhance reimbursement, strengthen operational workflows, and mitigate revenue leakage.
- Serve as the primary departmental resource for revenue cycle operations and performance.
- Provide ongoing monitoring and oversight of revenue cycle metrics and operational workflows.
- Collaborate with operational leadership, providers, Finance, Coding, Revenue Integrity, and Patient Financial Services to address issues impacting reimbursement and revenue cycle performance.
- Identify operational risks, process failures, and performance gaps affecting revenue capture and reimbursement.
- Maintain accountability for issue resolution and follow-through across multiple stakeholders.
- Monitor professional charge capture performance across clinical, procedural, and ambulatory services.
- Reconcile clinical activity, scheduling activity, procedural volumes, and billing activity to identify missed or delayed charges.
- Investigate charge capture discrepancies and coordinate resolution with providers, coding teams, practice operations, and revenue integrity personnel.
- Monitor charge lag reports and identify trends requiring operational intervention.
- Support implementation of charge capture workflows for new providers, services, programs, and practice locations.
- Monitor denial trends by provider, payer, location, service line, procedure, and denial category.
- Conduct root cause analysis of recurring denial patterns and reimbursement variances.
- Collaborate with coding, authorization, contracting, and revenue cycle teams to implement corrective actions.
- Support initiatives designed to improve first-pass claim acceptance and reduce preventable denials.
- Develop, maintain, and analyze revenue cycle reports, dashboards, and performance metrics.
- Monitor charge lag, missing charges, denial rates, reimbursement trends, AR performance, write-offs and revenue leakage indicators.
- Prepare routine and ad hoc reports for department leadership and executive management.
- Present findings and recommendations to operational and physician leadership.
- Serve as the primary revenue cycle liaison to physicians and advanced practice providers.
- Identify recurring documentation issues affecting coding accuracy and reimbursement performance.
- Coordinate provider education efforts in partnership with Coding, Compliance, and Revenue Integrity teams.
- Promote provider accountability for timely documentation and charge submission practices.
- Evaluate workflows affecting billing, reimbursement, charge capture, and denial performance.
- Participate in Epic optimization initiatives and system enhancement projects.
- Assist with workflow redesign, testing, implementation planning, and operational adoption of system enhancements.
- Establish partnerships with operational leaders, physicians, Finance, Revenue Integrity, Coding, Compliance, Information Systems, Managed Care, and Patient Financial Services teams.
- Serve as a departmental subject matter expert on revenue cycle operations and reimbursement-related workflows.
- Lead and support revenue cycle improvement initiatives and operational performance projects.
- Support implementation of enterprise revenue cycle initiatives, process standardization efforts, and strategic projects.
Bachelor's degree in Healthcare Administration, Business Administration, Finance, Health Information Management, Accounting, or related field required. Equivalent combination of education and experience may be considered.
Minimum five (5) years of experience in healthcare revenue cycle, physician practice operations, healthcare finance, reimbursement, revenue integrity, or related healthcare operations. Experience with Epic strongly preferred.
Experience in an academic medical center, integrated health system, or large physician group. Knowledge of CPT, ICD-10, reimbursement methodologies, and revenue integrity principles. CRCR, CPC, CPMA, CHRI, HFMA, or similar certification preferred.
No direct supervisory responsibility. May provide project leadership and functional oversight for revenue cycle initiatives.
$64,480.00-$106,412.80
Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.
LPG-East Providence-950 Warren Ave - 950 Warren Avenue East Providence, Rhode Island 02914
M-F 8a-5p
Day
8 hours
No
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