RCM Analyst
Role Overview
OrthoMed Anesthesia seeks an experienced RCM Analyst to support revenue-cycle performance analysis, process improvement, and operational and financial decisions.
This is a full-time, on-site role accountable for monitoring end-to-end revenue-cycle processes and translating findings into recommendations to improve reimbursement and reduce payment delays.
The role requires independent analysis, sound prioritization, and the ability to influence cross-functional stakeholders with data-driven recommendations.
Key Skills for This Role
Full Job Posting
Position overview
OrthoMed Anesthesia seeks an experienced RCM Analyst to support revenue-cycle performance analysis, process improvement, and operational and financial decisions.
This is a full-time, on-site role accountable for monitoring end-to-end revenue-cycle processes and translating findings into recommendations to improve reimbursement and reduce payment delays.
The role requires independent analysis, sound prioritization, and the ability to influence cross-functional stakeholders with data-driven recommendations.
Key responsibilities
- Analyze performance across scheduling, intake, scrubbing, claims submission, denials, rejections, payment posting, accounts receivable, aging, and payer performance; identify root causes and quantify financial impact.
- Own recurring reports, dashboards, and KPI frameworks, and deliver ad hoc analyses with recommendations for corrective action.
- Analyze billing, coding, clearinghouse, payer, and payment data to identify systemic errors, process gaps, and workflow inefficiencies.
- Establish data-validation standards for source files, billing outputs, clearinghouse responses, payer remittances, and internal tracking tools.
- Drive projects in reporting automation, process improvement, system optimization, claims lifecycle tracking, and billing workflow redesign.
- Present findings, advise leaders and operational teams on process changes, and mentor junior staff on analytical methods as needed.
- Protect confidential patient, payer, provider, and business information and follow applicable privacy and compliance requirements.
Required qualifications
- Bachelor’s degree in a related field, or an equivalent combination of education and experience.
- At least three years in healthcare RCM, medical billing, claims processing, accounts receivable, denial management, or healthcare data analysis, including at least two years in a lead or senior analytical capacity.
- Ability to analyze complex datasets, identify trends and root causes, and communicate findings concisely to executive audiences.
- Ownership, judgment, follow-through, and ability to manage competing priorities independently.
- Advanced analytical, communication, and process-improvement skills, including change-leadership experience.
- Advanced billing-software and Microsoft Excel proficiency, including pivot tables, lookups, and complex formulas.
Preferred qualifications
- Certification such as CRCR, CPC, CPMA, or CHAA.
- Deep knowledge of revenue cycle management and payer reimbursement dynamics.
- Working knowledge of ANSI X12 EDI transaction sets, including 837, 835, 999, 997, 276/277, and 270/271.
- Hands-on experience with SQL, Snowflake, Power BI, or similar data and reporting tools.
- Experience using AI tools such as Claude or Microsoft Copilot for analysis and reporting.
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