Revenue Cycle Operations Specialist - GI

BHMG Lifespan Physician Group, Inc., d/b/a Brown Health Medical Group

East Providence (RI)

On-site

USD 64,000 - 106,000

Full time

5 days ago
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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 revenue capture and minimize leakage.

This role focuses on monitoring metrics, charge capture, denial prevention, and workflow improvements, including Epic optimization and system

Qualifications

  • Bachelor's degree in Healthcare Administration, Business Administration, Finance, Health Information Management, Accounting, or related field required.
  • 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.
  • Knowledge of CPT, ICD-10, reimbursement methodologies, and revenue integrity principles.

Responsibilities

  • Lead revenue cycle operations and performance for assigned departments.
  • Monitor metrics and optimize reimbursement and workflows.
  • Identify operational risks and resolve issues across stakeholders.
  • Monitor charge capture and resolve discrepancies with providers and coding teams.
  • Analyze denials and implement corrective actions to reduce leakage.
  • Develop and present revenue cycle reports to leadership.
  • Collaborate with providers, coding, compliance, and revenue integrity teams.
  • Assist Epic optimization and system improvement projects.

Skills

Epic experience
Revenue cycle knowledge
Analytical skills
Cross-functional collaboration

Education

Bachelor's degree in Healthcare Administration, Business Administration, Finance, Health Information Management, Accounting, or related field
CRCR, CPC, CPMA, CHRI, HFMA or similar certification preferred

Tools

Epic systems

Job description

POSITION SUMMARY

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.

RESPONSIBILITIES

Revenue Cycle Operations and Performance Management 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.

Charge Capture and Revenue Integrity 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.

Denial Prevention and Reimbursement Optimization 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.

Reporting, Analytics, and Financial Performance 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.

Provider Collaboration and Documentation Support 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.

Workflow Optimization and System Improvement 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.

Cross-Functional Collaboration 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.

Continuous Improvement and Special Projects Lead and support revenue cycle improvement initiatives and operational performance projects. Support implementation of enterprise revenue cycle initiatives, process standardization efforts, and strategic projects.

REQUIRED QUALIFICATIONS

Education: 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.

Experience: 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.

Preferred Qualifications: 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.

Supervisory Responsibility: No direct supervisory responsibility. May provide project leadership and functional oversight for revenue cycle initiatives.

Pay Range: $64,480.00-$106,412.80

EEO Statement

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location

LPG-East Providence-950 Warren Ave - 950 Warren Avenue East Providence, Rhode Island 02914

Work Type: M-F 8a-5p

Work Shift: Day

Daily Hours: 8 hours

Driving Required: No

As Rhode Island's largest health system and private employer, Brown University Health is the state's premier provider of health services and includes the only Level I Trauma Center for southeastern New England.

Today, more than 20,000 people work at Brown University Health and bring their unique skills, experiences, and compassion to their jobs every day.

Formed in 1994, Brown University Health is a not-for-profit health system based in Providence, RI comprising three teaching hospitals of The Warren Alpert Medical School of Brown University: Rhode Island Hospital and its Hasbro Children's; The Miriam Hospital; and Bradley Hospital, the nation’s first psychiatric hospital for children; Newport Hospital, Saint Anne's Hospital and Morton Hospital, community hospitals offering a broad range of health services; Gateway Healthcare, the state’s largest provider of community behavioral health care; and Brown Health Medical Group, the largest multi‑specialty practice in Rhode Island.

Brown University Health is an equal opportunity employer that values diversity of cultural background, race, gender, age, religion, identity, ability, and perspectives - we are actively committed to a diverse workforce that represents the patients and community that we serve.

We are invested in creating a respectful, inclusive, and equitable environment that supports the holistic well‑being of our employees and their families.

Join us and help build a healthier future for our patients - and for yourself.

Company Location Belonging and Engagement Nursing Our Mission

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