Senior Revenue Cycle Analyst: Analytics & Reconciliation

TeamCare Medical; New York (NY); Hybrid; USD 80,000 - 90,000; Full time

Job summary

CenterLight Health System in New York, NY seeks a Revenue Cycle Analyst II to manage billing and analytics for the organization’s revenue cycle. You will lead day-to-day operations, produce analytics, and guide junior staff to ensure accurate reconciliation of payments and compliant reporting.

The role requires 3-5 years in healthcare, proficiency in SAS/SQL, and strong communication skills. A CPC is a plus.

Qualifications

• Bachelor's degree is required.
• Certified Professional Coder (CPC) a plus.
• 3-5 years healthcare experience in a managed care setting is required.
• Proficiency in data analytics, i.e. SAS, SQL is required.
• Claims adjudication and understanding of claims PPS is strongly preferred.
• Knowledge of Medicaid and Medicare benefits, enrollment and billing, and provider contracting is required.
• Knowledge of CPTs, ICD-9/ICD-10, HCPCS, DRG, Revenue, RBRVS.
• Proficiency in MS Excel, Word, PowerPoint, and experience using a claims processing system or comparable database software.
• Effective oral, written, and interpersonal communication skills are required.
• Able to multitask efficiently, effectively, and timely.
• Strong organizational skills and work ethic.
• Detail-oriented, professional and collaborative, a great team player.

Responsibilities

• Perform weekly billing for Best Choice/Matter of Care in coordination with Coordinators and Payroll.
• Enter and independently reconcile insurance and member payments to accounts receivable.
• Perform full analytics on all revenue operations for all lines of business.
• Analyze (MMR and 820/834) and reconcile payments to billing files.
• Investigate and resolve Enrollment/Intake discrepancies for correction or rebilling.
• Coordinate with Enrollment on PDE rejections and CMS-related issues.
• Coordinate with Enrollment on MSP letters and correction of discrepancies in ECRS.
• Identify members with Surplus, NAMI, or Pool Trust balances and resolve related issues.
• Work with Enrollment/Intake on eligibility issues.
• Perform monthly MMR analysis and work with CMS MAPD Helpdesk to open/resolvetickets.
• Coordinate with Dialysis providers to obtain 2728 forms and activate ESRD indicators.
• Prepare monthly GL entries related to revenue.
• Assist Actuarial with data analytics as needed.
• Develop and maintain financial reporting and analytics in Tableau/Power BI (KPIs) used by senior leadership.
• Prepare ad hoc financial modeling, analysis, and projections.
• Serve as mentor to Revenue Cycle Analyst I staff.
• Contribute to SOPs and process improvements.
• Create SQL queries/store procedures for team use.
• Identify revenue enhancing opportunities.
• Work on special projects.

Skills

Analytical thinking

Communication

Multitasking

Organizational skills

Team player

Attention to detail

Education

Bachelor's degree

Tools

SAS

SQL

MS Excel

PowerPoint

Job description

CenterLight Health System in New York, NY seeks a Revenue Cycle Analyst II to manage billing and analytics for the organization’s revenue cycle. You will lead day-to-day operations, produce analytics, and guide junior staff to ensure accurate reconciliation of payments and compliant reporting.

The role requires 3-5 years in healthcare, proficiency in SAS/SQL, and strong communication skills. A CPC is a plus.