Senior Analyst, RCM Data – Technology

Job not on LinkedIn

🔥 1 hour ago

⚜️ Louisiana – Remote

⚜️ Louisiana – Remote

⏰ Full Time

🟠 Senior

🧐 Analyst

👻 Ghost score 19%

What it means: how likely this posting is sitting open without active hiring.How to read it: 60% or higher means we think this is a ghost. Lower scores are less of a worry.How we score it: age, reposts, open roles vs team size, how fast jobs close, and whether pay is listed.Fine print: an estimate from public data, not a judgment of the company. Real jobs can score high, so treat it as a hint, not a fact.

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Core Health LLC

WebsiteLinkedInAll Job Openings

51 - 200 employees

🏥 Healthcare

⚕️ Healthcare Insurance

🌍 Social Impact

Healthcare • Healthcare Insurance • Social Impact

Core Health LLC is a Health Services Management company specializing in managing at-risk patients, including the elderly, disabled, and those eligible for Medicaid and Medicare-Medicaid programs. The company collaborates with integrated health systems, Medicare Advantage Plans, and Accountable Care Organizations to enhance patient care in their communities. They also operate Health Alliance Connect, an integrated care program focused on seniors and individuals with disabilities.

📋 Description

• Analyze, optimize, and maintain data, technology, and reporting processes supporting Revenue Cycle Management operations • Ensure completeness, accuracy, timeliness, and integrity of clinical and financial data across the revenue cycle ecosystem • Partner with Revenue Cycle Operations, IT, Coding, Billing, Provider Enrollment, hospital partners, and external technology vendors • Identify data integrity issues and monitor system interfaces and chart acquisition • Develop reconciliation, exception, executive, operational, and RCM performance reporting • Develop, enhance, and support RCM data warehouse processes, reporting, chart integrity databases, payer connectivity, system integrations, and automated monitoring • Monitor data flows across hospital EMRs/EHRs, coding platforms, clearinghouses, payer systems, provider enrollment systems, financial reporting platforms, and other RCM applications • 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 • Support payer connectivity and automation for eligibility, authorization, claims, disputes, and related functions • Develop and monitor KPIs for chart integrity, encounter reconciliation, coding, claims, payer connectivity, data quality, revenue leakage, and system performance • 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 • Coordinate data validation, troubleshooting, and sustainable solutions with teams and vendors • Maintain hospital contacts, 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

🎯 Requirements

• Bachelor’s Degree in Information Technology, Computer Science or related field • Minimum 5 years’ experience in an IT Management position • EHR/EMR experience required • Prior experience in the healthcare sector required • Experience using Microsoft Excel to analyze and organize large volumes of data for trending/exception reporting • Chart Auditing/Optimization experience preferred • Reliable access to internet when working remotely • Strong analytical, critical-thinking, and problem-solving skills • Ability to translate data, technology, and business requirements into actionable insights and recommendations • Strong understanding of data, technology, systems, and analytical concepts • Ability to assess business and operational requirements and support technology-enabled solutions • Excellent written and verbal communication skills • Ability to collaborate with internal and external stakeholders • Ability to manage multiple complex priorities and strict deadlines • Ability to maintain confidentiality and handle sensitive information appropriately

🏖️ Benefits

• Remote work arrangement • Travel for in-person meetings and events • Reliable internet access while working remotely • Equal opportunity employer • Drug-free workplace • ADA compliance as applicable