Revenue Cycle Optimization Analyst - Remote/Hybrid

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

Benefits offered by this job

Paid vacation days

Sick leave

Medical, dental, and vision insurance

DailyPay – access earnings

Training, development, and growth

401(k)

Employee Assistance Program (EAP)

Pet insurance

Perks @ Clarvida – national discounts

Job summary

Clarvida is seeking a Revenue Cycle Operations Analyst to support California Operations by optimizing front-end revenue cycle performance across programs. You will serve as the SME for eligibility verification, payer requirements, authorization management, financial clearance, and billing readiness.

You will collaborate with clinical, operational, and leadership teams to identify improvements, develop procedures and KPIs, and reduce denial risk while driving data-driven performance across the

Qualifications

• Bachelor's degree in healthcare/related field required.
• Minimum three years of revenue cycle or billing operations experience.
• Experience interpreting Medi-Cal, Medi-Medi, commercial payer requirements.
• Experience with EHR/billing platforms such as IRIS or Avatar.
• Advanced proficiency in Microsoft Excel and reporting tools.
• Strong analytical and problem-solving skills.
• Ability to exercise independent judgment on complex operational issues.

Responsibilities

• Analyze front-end revenue cycle workflows and billing readiness across programs.
• Interpret Medi-Cal, Medi-Medi, payer rules and provide operational guidance.
• Develop and maintain revenue cycle procedures, controls and best practices.
• Prioritize revenue cycle issues and coordinate corrective actions with leadership.
• Review billing errors and trends to identify root causes and improvements.
• Develop and monitor KPIs, dashboards, scorecards, and reports.
• Present findings and action plans to leadership and stakeholders.
• Design and deliver training on payer requirements, eligibility, and billing readiness standards.

Skills

Eligibility Verification

Payer Requirements

Data Analysis

KPI Reporting

Excel Proficiency

Problem Solving

Independent Judgment

Healthcare Analytics

Education

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

Tools

IRIS

Avatar

Job description

Clarvida is seeking a Revenue Cycle Operations Analyst to support California Operations by optimizing front-end revenue cycle performance across programs. You will serve as the SME for eligibility verification, payer requirements, authorization management, financial clearance, and billing readiness.

You will collaborate with clinical, operational, and leadership teams to identify improvements, develop procedures and KPIs, and reduce denial risk while driving data-driven performance across the