RCM Analyst

Position Overview

OrthoMed Anesthesia is seeking an experienced RCM Analyst to support revenue cycle performance analysis, drive process improvement, and deliver insights that shape operational and financial decisions. This full-time, on-site role will be accountable for monitoring end-to-end revenue cycle processes, and for translating complex findings into strategic recommendations that improve reimbursement, reduce payment delays, and inform leadership decisions.

The ideal candidate brings a proven record of independent analysis, sound judgment in prioritizing issues across competing demands, and the ability to influence cross-functional stakeholders with clear, data-driven recommendations.

Key Responsibilities

- Lead analysis of revenue cycle performance across scheduling, intake, scrubbing, claims submission, denials, rejections, payment posting, accounts receivable, aging, and payer performance, identifying root causes and quantifying financial impact.

- Design and own recurring reports, dashboards, and KPI frameworks, and deliver ad hoc analyses that inform leadership on performance, variances, and recommended corrective actions.

- Evaluate billing, coding, clearinghouse, payer, and payment data, including denial and rejection patterns by payer, facility, provider, procedure, modifier, or diagnosis, to diagnose systemic errors, process gaps, and workflow inefficiencies and recommend prioritized corrective actions.

- Establish and oversee data validation standards across source files, billing system outputs, clearinghouse responses, payer remittances, and internal tracking tools.

- Scope, prioritize, and drive special projects in reporting automation, process improvement, system optimization, claims lifecycle tracking, and billing workflow redesign.

- Serve as a trusted resource to revenue cycle leadership and operational teams by presenting findings, advising on process changes, and mentoring junior staff on analytical methods where needed.

- Safeguard the confidentiality of patient, payer, provider, and business information, and ensure adherence to all applicable privacy and compliance requirements.

Required Qualifications

- Bachelors degree in a related field, or an equivalent combination of education and experience.

- Three or more years of experience in healthcare revenue cycle management, medical billing, claims processing, accounts receivable, denial management, or healthcare data analysis, including at least two years in a lead or senior analytical capacity.

- Demonstrated ability to analyze large, complex datasets, identify trends and root causes, and communicate findings concisely to executive audiences.

- Strong ownership, judgment, and follow-through, with a proven ability to manage competing priorities independently.

- Advanced analytical, communication, and process-improvement skills, including experience leading change.

- Advanced proficiency with billing software and Microsoft Excel, including pivot tables, lookups, and complex formulas.

Preferred Qualifications

- Certification such as CRCR, CPC, CPMA, or CHAA.

- Deep working 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 to accelerate analysis and reporting.