Senior Analyst, RCM Data & Technology

Description

Core Clinical Partners stands at the forefront of Emergency and Hospital Medicine, delivering unparalleled services through a model that emphasizes patient-centric care and operational excellence. Our corporate values – Genuine, Accountable, Dynamic, Respectful, and Fun – are the pillars that uphold our commitment to revolutionize healthcare delivery.

The Senior Analyst, Revenue Cycle Management (RCM) Data & Technology is responsible for analyzing, optimizing, and maintaining the data, technology, and reporting processes that support Revenue Cycle operations across Emergency and Hospital Medicine services. This role focuses on ensuring the completeness, accuracy, timeliness, and integrity of clinical and financial data throughout the revenue cycle ecosystem.

The Senior Analyst serves as a key business partner to Revenue Cycle Operations, Information Technology, Coding, Billing, Provider Enrollment, Hospital Partners, and external technology vendors. The role is responsible for identifying data integrity issues, monitoring system interfaces and chart acquisition, developing reconciliation and exception reporting, and supporting technology solutions that improve revenue capture, operational efficiency, and scalability.

This position will have significant responsibility for the development, enhancement, and ongoing support of RCM data warehouse processes, reporting, chart integrity databases, payer connectivity, system integrations, and automated monitoring. The Senior Analyst will translate operational requirements into data and technology solutions and will work collaboratively with internal and external stakeholders to resolve issues and improve RCM performance.

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:

• Bachelor’s Degree in Information Technology, Computer Science or related field.

Experience:

• Minimum 5 years’ experience in IT Management position. 
• EHR/EMR experience required. 
• Chart Auditing/Optimization experience preferred. 
• Prior experience in the healthcare sector required. 
• Experience using Microsoft excel in analyzing and organizing large volumes of data for trending/exception reporting.  

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.