Revenue Operations Analyst

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🏄 California – Remote

🏄 California – Remote

⏰ Full Time

🟡 Mid-level

🟠 Senior

💹 Revenue Operations

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Community Memorial Healthcare

WebsiteLinkedInAll Job Openings

1001 - 5000 employees

Founded 1902

🏥 Healthcare

⚕️ Healthcare Insurance

🤝 Non-profit

Healthcare • Healthcare Insurance • Non-profit

Community Memorial Healthcare is a trusted leader in local healthcare, known for providing exceptional care with a renewed passion for partnering with patients. With a wide range of services, including emergency care, surgery, rehabilitation, and specialty care, it operates in various health centers and hospitals in Ventura and Ojai. The organization is committed to community service, offering programs like residency training and community health assessments. Supported by community donations, Community Memorial Healthcare invests in advanced medical technology and education to enhance patient care and community partnerships.

📋 Description

• Manage the day-to-day operations of denials management, appeals, self-pay inventory, claims write-offs, client edits, client portal usage, payer policy changes, AR aging across all payer classes, insurance eligibility, and insurance discovery trends • Oversee, maintain, and communicate denials and appeals activity to clients and internal stakeholders • Provide guidance and direction to the team to maintain or exceed goals for total AR collections, credit balances, edits and denials • Identify emerging trends in claims payments and assess expected versus actual reimbursement • Ensure activities comply with Cottage Health and PDL policies, procedures, and federal and state regulations • Assist with recruitment, retention, training, and work allocation

🎯 Requirements

• Bachelor's degree or equivalent Lab RCM work experience of 6 years • Five years of LAB RCM experience, preferably in a multi-facility environment • Three years of progressive responsibility in healthcare revenue cycle • Understanding of ICD-10 coding for laboratory CPTs • Experience working payer denials and appeal processes • Expertise in healthcare insurance eligibility, verification, and claims filing procedures • Expertise using software applications to maximize automation and efficiency in a business office setting • Proficiency in Microsoft Office, especially Excel and PowerPoint • Ability to analyze data to identify trends and process-improvement opportunities • Experience with legal consent policies and procedures and payer contracting and policies • Knowledge of medical terminology • MS-Office 365 preferred

🏖️ Benefits

• Eligible employees may receive shift differentials, on-call pay, incentive pay, and bonus opportunities, where applicable • Manager and above positions may participate in Cottage Health’s annual management incentive program • Comprehensive Total Rewards offerings