RCM Business Analyst

The Emily Program is dedicated to providing exceptional, individualized care for those with eating disorders. The RCM Business Analyst plays a critical role in supporting the Revenue Cycle Management team by providing operational and technical support, ensuring optimal billing performance, and driving process improvements.

Responsibilities:

• Provide real-time support to the RCM team to resolve production billing issues
• Address billing discrepancies identified through claim remittances and clearinghouse status reports
• Serve as the primary point of contact for EHR billing corrections and system-related revenue issues
• Research system functionality to support enhancements, new workflows, and billing optimization initiatives
• Maintain accurate documentation of system configuration changes within the EHR platform
• Analyze complex data sets to identify revenue leakage, denial trends, billing errors, and reimbursement variances
• Develop and maintain dashboards, KPIs, and standardized reporting to support operational and strategic decision-making
• Monitor performance metrics across the full revenue cycle, including patient access, coding, billing, denials, and A/R
• Assist with ad hoc and routine reporting needs as required
• Translate business requirements into clear technical specifications for IT and data teams
• Play a lead role in billing support and optimization within the EHR system
• Assist with system upgrades and ensure billing configurations remain intact during implementations
• Participate in validation testing for new design/build initiatives related to Practice Management functionality
• Assist in writing business requirements for new system builds and reporting enhancements
• Partner with EHR training teams to ensure billing-related training materials remain current and accurate
• Collaborate with Patient Access, HIM, Billing, Collections, and other departments to streamline workflows and resolve systemic issues
• Support projects related to EHR upgrades, payer contract changes, and revenue integrity initiatives
• Monitor regulatory and payer policy changes impacting reimbursement
• Participate in cross-functional meetings and provide analytical insight to support revenue-related initiatives
• Keep management informed of workflow disruptions, risks, or emerging concerns
• Evaluate business processes and recommend automation and efficiency improvements
• Support revenue optimization strategies and continuous improvement efforts
• Contribute to the development and implementation of standardized, streamlined billing content and workflows

Requirements:

• High School Diploma or equivalent required
• Minimum of 5 years of Revenue Cycle experience in a healthcare environment
• Strong knowledge of end-to-end revenue cycle processes, including: Patient Access, Charge Capture, Coding, Claims (837I/837P loops and segments), Denials management, Cash posting and A/R follow-up
• Knowledge of CMS billing regulations and reimbursement methodologies
• Understanding of claim remittance codes, posting codes, and service codes
• Experience working with clearing houses and payer systems
• Proficiency in Microsoft Office (Excel, Word, Outlook)
• Strong written and verbal communication skills
• Demonstrated ability to communicate effectively with peers, leadership, providers, and vendors
• Strong customer service and communication skills
• Excellent written and verbal communication
• Ability to communicate effectively with peers, senior management and providers
• Strong analytical and problem-solving skills
• Exceptional attention to detail and commitment to quality
• Excellent time management and ability to manage multiple assignments simultaneously
• Ability to work independently and exercise sound judgment
• Strong interpersonal skills with the ability to build productive relationships
• Adaptability in a fast-paced, changing environment
• Customer service–oriented mindset
• Demonstrated initiative and accountability
• Associate degree or bachelor's degree in information systems, Business Administration, Healthcare Administration, Finance, or related field preferred
• Experience with data visualization and reporting tools (e.g., Excel, SQL, Tableau, Power BI, Smart Sheets) preferred
• Experience with major EHR systems (e.g., Epic, Cerner, Meditech, NX Avatar) preferred
• Familiarity with DRG, APC, CPT/HCPCS methodologies preferred
• Lean Six Sigma or process improvement certification preferred
• Experience in predictive analytics or healthcare data modeling preferred
• Experience in predictive analytics or machine learning models in healthcare preferred