Senior Analyst, RCM Data & Technology

Essential Duties

• Optimize RCM data, technology, and reporting for accurate, timely revenue capture.
• Advance the RCM data warehouse, reporting, and integrity roadmap.
• Serve as the RCM data integrity, chart acquisition, reconciliation, and reporting expert.
• Monitor data flows among:
• -Hospital EMRs/EHRs
• -Coding platforms
• -Clearinghouses
• -Payer systems
• -Provider Enrollment systems
• -Financial reporting platforms
• -Other RCM applications and technology vendors
• Resolve missing, duplicate, delayed, incomplete, or inaccurate clinical and financial data.
• Maintain encounter-to-billing reconciliations and identify revenue-cycle gaps.
• Maintain and enhance the Chart Integrity Database and reporting.
• Automate exception monitoring for acquisition, interface, workflow, data, and revenue issues.
• Analyze RCM trends to identify operational and financial opportunities.
• Develop, test, implement, and optimize HL7, API, EDI, and other RCM interfaces.
• Partner with IT, vendors, and hospitals to resolve interface and data issues.
• Monitor vendor feeds and coordinate fixes for data or chart acquisition issues.
• Support payer connectivity and automation for eligibility, authorization, claims, disputes, and related functions.
• Maintain executive, operational, and exception reporting on RCM performance and data integrity.
• Develop and monitor KPIs for:
• -Chart integrity and acquisition
• -Encounter reconciliation
• -Coding performance
• -Claims processing
• -Payer connectivity
• -Data completeness and accuracy
• -Revenue leakage
• -Interface and system performance
• Use data to identify trends, root causes, inefficiencies, and performance opportunities.
• Translate business needs into reporting, analytics, automation, and technology solutions.
• Support system implementations, upgrades, testing, workflow changes, and enhancements.
• Document requirements, workflows, test plans, and implementations for RCM initiatives.
• Coordinate data validation, troubleshooting, and sustainable solutions with teams and vendors.
• Maintain hospital contacts for chart integrity, record access, data acquisition, and RCM technology.
• Maintain RCM system access and data availability.
• Plan projects, set milestones, track deliverables, and report status.
• Automate manual processes to improve scalability, data quality, and efficiency.
• Provide analytical and technical support for strategic RCM initiatives and growth.
• Advise operational, financial, clinical, and technology stakeholders on RCM data and technology.
• Perform other related duties as assigned.

Skills, Knowledge, Abilities

• Strong organizational and time-management skills with the ability to manage multiple, complex priorities in a fast-paced environment while consistently meeting strict deadlines.
• Demonstrated ability to adapt, modify, and reprioritize work in response to changing business needs, competing priorities, and organizational objectives.
• Strong analytical, critical-thinking, and problem-solving skills, with the ability to independently analyze complex data, identify trends and opportunities, evaluate issues, and develop effective solutions.
• Advanced ability to translate data, technology, and business requirements into actionable insights and recommendations that support revenue cycle management and operational improvement.
• Demonstrated ability to identify process, data, and technology improvement opportunities; take initiative; and implement solutions that enhance efficiency, accuracy, quality, and organizational performance.
• Excellent written, verbal, communication, and interpersonal skills, with the ability to effectively communicate complex technical, analytical, and business information to diverse audiences.
• Proven ability to collaborate effectively with internal and external stakeholders, including cross-functional teams and professionals across departments, geographic locations, and organizational levels.
• Demonstrated ability to build productive working relationships and contribute to a collaborative, team-oriented environment while maintaining accountability for individual responsibilities and deliverables.
• Strong understanding of data, technology, systems, and analytical concepts, with the ability to learn, navigate, and effectively utilize proprietary software applications and evolving technology platforms.
• Ability to assess business and operational requirements, analyze data and system information, and support the development and implementation of technology-enabled solutions.
• Demonstrated growth mindset with a commitment to continuous learning, professional development, process improvement, and the adoption of new technologies and methodologies.
• Self-motivated and results-oriented, with the initiative to work independently, exercise sound judgment, manage ambiguity, and escalate issues appropriately.
• Ability to navigate competing priorities, manage complex assignments, and maintain a high level of accuracy and attention to detail in a deadline-driven environment.
• Demonstrated ability to maintain confidentiality, exercise discretion, and handle sensitive business, financial, operational, and data-related information appropriately.
• Ability to lead through influence, facilitate collaboration, and effectively communicate with stakeholders to drive alignment and support organizational goals.
• Exhibit growth mindset and team-oriented behaviors.
• Requirements

Education

Experience

Work Location

• Remote work with travel for in-person meetings and events. When working remotely, the employee must have reliable access to internet.
• Core Clinical Partners is an equal opportunity employer, drug-free workplace, and complies with ADA regulations as applicable.Please note this job description is not designed to cover or contain a comprehensive listing of activities, duties or responsibilities that are required of the employee for this job. Duties, responsibilities, and activities may change at any time with or without notice.

Requirements

• Strong organizational and time-management skills with the ability to manage multiple, complex priorities in a fast-paced environment while consistently meeting strict deadlines.
• Demonstrated ability to adapt, modify, and reprioritize work in response to changing business needs, competing priorities, and organizational objectives.
• Strong analytical, critical-thinking, and problem-solving skills, with the ability to independently analyze complex data, identify trends and opportunities, evaluate issues, and develop effective solutions.
• Advanced ability to translate data, technology, and business requirements into actionable insights and recommendations that support revenue cycle management and operational improvement.
• Demonstrated ability to identify process, data, and technology improvement opportunities; take initiative; and implement solutions that enhance efficiency, accuracy, quality, and organizational performance.
• Excellent written, verbal, communication, and interpersonal skills, with the ability to effectively communicate complex technical, analytical, and business information to diverse audiences.
• Proven ability to collaborate effectively with internal and external stakeholders, including cross-functional teams and professionals across departments, geographic locations, and organizational levels.
• Demonstrated ability to build productive working relationships and contribute to a collaborative, team-oriented environment while maintaining accountability for individual responsibilities and deliverables.
• Strong understanding of data, technology, systems, and analytical concepts, with the ability to learn, navigate, and effectively utilize proprietary software applications and evolving technology platforms.
• Ability to assess business and operational requirements, analyze data and system information, and support the development and implementation of technology-enabled solutions.
• Demonstrated growth mindset with a commitment to continuous learning, professional development, process improvement, and the adoption of new technologies and methodologies.
• Self-motivated and results-oriented, with the initiative to work independently, exercise sound judgment, manage ambiguity, and escalate issues appropriately.
• Ability to navigate competing priorities, manage complex assignments, and maintain a high level of accuracy and attention to detail in a deadline-driven environment.
• Demonstrated ability to maintain confidentiality, exercise discretion, and handle sensitive business, financial, operational, and data-related information appropriately.
• Ability to lead through influence, facilitate collaboration, and effectively communicate with stakeholders to drive alignment and support organizational goals.
• Exhibit growth mindset and team-oriented behaviors.
• Requirements