Senior Revenue Cycle Analyst - Billing & Analytics

C2Q Health Solutions; New York (NY); On-site; USD 80,000 - 90,000; Full time

Job summary

CenterLight is seeking a Revenue Cycle Analyst to manage end-to-end billing operations, perform analytics, and support senior leadership with KPI dashboards in Tableau/Power BI. This role requires strong data skills, attention to detail, and the ability to mentor staff on daily tasks and procedures.

The ideal candidate will have 3-5 years in healthcare revenue cycle, proficiency in SAS/SQL, and experience with enrollment, eligibility, and CMS/DOH guidelines. Monday-Friday, 40 hours.

Qualifications

• 3-5 years of healthcare experience in managed care setting.
• Proficiency in data analytics, SAS and SQL required.
• Knowledge of CPT, ICD 9/ICD 10, HCPC, DRG, Revenue, RBRVS.
• Experience with claims adjudication and enrollment/billing processes.
• Strong MS Excel, Word, PowerPoint skills and experience with a claims processing system.

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 A/R.
• Perform full analytics on all revenue operations for all Line of Business of Centerlight.
• Perform analytics (on MMR and 820/834) and reconciliation of payments received to billing files.
• Independently investigate and resolve Enrollment/Intake discrepancies for correction/rebilling.
• Coordinate with Enrollment on PDE rejections and assist the Enrollment team with 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 the Enrollment/Intake team to resolve eligibility issues.
• Perform monthly MMR analysis and work with the CMS MAPD Helpdesk to open and resolve tickets.
• Coordinate with Dialysis providers to obtain 2728 forms and work with the CMS MAPD Helpdesk to activate member 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 (including KPI dashboards) used by senior leadership to track actual results vs. target.
• Prepare ad hoc financial modeling, analysis, and projections.
• Serve as a resource and informal mentor to Revenue Cycle Analyst I staff on daily tasks, tools, and procedures.
• Contribute to process improvement initiatives and document standard operating procedures (SOPs).
• Create SQL queries/ store procedures for use by other members of the team.
• Work of developing process to identify revenue enhancing opportunities.
• Work on special projects as assigned.

Skills

SAS

SQL

Excel

PowerPoint

Communication skills

Multitasking

Teamwork

Education

Bachelor's degree

Certified Professional Coder (CPC) a plus

Tools

Tableau

Power BI

Job description

CenterLight is seeking a Revenue Cycle Analyst to manage end-to-end billing operations, perform analytics, and support senior leadership with KPI dashboards in Tableau/Power BI. This role requires strong data skills, attention to detail, and the ability to mentor staff on daily tasks and procedures.

The ideal candidate will have 3-5 years in healthcare revenue cycle, proficiency in SAS/SQL, and experience with enrollment, eligibility, and CMS/DOH guidelines. Monday-Friday, 40 hours.