Hospital Revenue Cycle Specialist - Data… at The Spine… · Baton…

Description

POSITION SUMMARY

The Hospital Revenue Cycle Specialist - Data Analyst & Project Manager is responsible for leading cross-functional revenue cycle projects and providing advanced analytical support to improve financial performance, compliance, and operational efficiency. This on-site position combines high-level data analysis with hands-on project management to drive improvement across scheduling, registration, authorization, coding, billing, revenue integrity, and clinical workflows. 

This position has a dotted-line reporting relationship to the Information Technology Director to ensure alignment with system architecture, data governance, and integration efforts. The Analyst also works closely with the Accounting Analyst to provide financial reporting integrity, reconciliation accuracy, and consistent data interpretation across finance and revenue cycle functions.

ESSENTIAL JOB FUNCTIONS (including, but not limited to)

Data Analytics & Reporting

• Analyze revenue cycle KPIs, including AR days, DNFB, denial trends, charge lag, reimbursement variances, and operational bottlenecks.
• Develop recurring dashboards and ad-hoc reports using Excel, SQL, or similar tools.
• Monitor payer contract performance and expected reimbursement.
• Validate data sources to ensure accuracy and consistency across systems.

Project Management & Leadership

• Lead medium- and large-scale revenue cycle projects across hospital departments.
• Develop project plans, timelines, and charters; track milestones and ensure accountability.
• Facilitate meetings, drive communication, and remove barriers to project progression.
• Assist in identifying and vetting vendors for revenue cycle optimization
• Conduct current-state workflow assessments and design optimized future-state workflows.
• Support system upgrades, workflow enhancements, and technology implementations.
• Coordinate testing, validation, and adoption of new processes in Meditech Expanse, FinThrive, Experian, and related systems.

Denials, Revenue Integrity & Compliance

• Identify root causes of denials and develop corrective action strategies.
• Support internal and external audits, including DRG downgrades, clinical validation appeals, and documentation reviews.
• Monitor coding accuracy, documentation completeness, and charge capture processes.
• Stay current on CMS regulatory changes and payer billing requirements.

Cross Department Collaboration

• Work with Patient Access, Coding/HIM, Business Office, Case Management, IT, and clinical departments to resolve issues and improve workflows.
• Serve as a technical and analytical resource to leadership.
• Partner closely with the Information Technology team on system configurations, data integrity, and reporting automation.
• Maintain a strong working relationship with the Accounting Analyst to ensure alignment between revenue cycle data and financial reporting.
• Serve as a technical and analytical resource to leadership.
• Present findings to non-technical audiences in a clear and actionable format.
• Performs other duties as assigned.

Disclaimer: The statements above are intended to describe the general nature and level of work performed by individuals assigned to this position. They are not intended to be an exhaustive list of all responsibilities, duties, or skills required. Additional duties may be assigned as needed to support the organization’s ongoing operations and mission.

Requirements

Education:

• Bachelor’s degree in Healthcare Administration, Business, Finance, Data Analytics, or a related field required.

Experience – Required:

• Minimum of 3–5 years of hospital revenue cycle experience.
• Formal, hands-on project management experience leading cross-functional initiatives, building project plans, managing timelines, facilitating groups, etc.
• Strong understanding of hospital billing, coding concepts, payer rules, and reimbursement methodologies (DRG, APC, OPPS, ASC).

Experience – Preferred:

• Experience with Meditech Expanse, FinThrive, Experian/Passport, or similar HIS platforms.

Skills & Competencies:

• Advanced Excel skills required; SQL, Power BI, or Tableau strongly preferred.
• Proven ability to manage complex projects with multiple stakeholders.
• Strong analytical, critical-thinking, and problem-solving skills.
• Excellent written and verbal communication abilities.
• Ability to handle multiple priorities in a fast-paced environment.
• High attention to detail and commitment to data accuracy.

Performance Expectations

• Produce accurate, timely analytical deliverables.
• Successfully leads projects to completion within scope and timeline.
• Maintains strong internal partnerships and communication.
• Demonstrate initiative, problem-solving, and continuous improvement.
• Adheres to compliance, HIPAA, and organizational standards.

We are an equal opportunity employer, and all qualified applicants will receive consideration for employment without regard to race, color, religion, sex, sexual orientation, gender identity or expression, pregnancy, marital status, age, national origin, disability status, genetic information, protected veteran status, or any other characteristic protected by federal, state, or local law. Our company values diversity and inclusion, and we encourage all qualified applicants to apply for job openings.