About Plutus Health Inc.
Plutus Health Inc. is a leading provider of Revenue Cycle Management (RCM) services, certified in SOC2 compliance and recognized among the Inc. 5000 fastest-growing private companies. We specialize in revenue cycle optimization for hospitals, physician groups, and healthcare organizations across various specialties. Our commitment to innovation and excellence has earned us recognition as a 2024 EY Entrepreneur Of The Year finalist and one of the top 100 fastest-growing companies in Dallas.
Role Overview
We are seeking a Healthcare Business Analyst (BA) to drive process improvements, optimize revenue cycle operations, and support data-driven decision-making. This role requires a deep understanding of healthcare data, payer regulations, claims processing, and RCM workflows. The ideal candidate will collaborate with stakeholders, analyze business needs, and translate them into actionable insights and solutions.
Key Responsibilities Business & Data Analysis
- Analyze RCM data, payer trends, claims processing, and reimbursement models to identify inefficiencies and revenue opportunities.
- Develop data-driven reports, dashboards, and financial models to support strategic decision-making.
- Perform gap analysis to identify process inefficiencies and recommend improvements.
- Support compliance audits by ensuring adherence to payer regulations and industry standards.
Process Optimization & RCM Enhancement
- Work closely with operations, IT, and finance teams to streamline billing, coding, and denial management processes.
- Identify revenue leakage and implement corrective actions to improve cash flow and collections.
- Assist in technology implementation projects (EHR, billing software, analytics tools) to enhance efficiency.
- Develop business cases for automation, workflow enhancements, and system integrations.
Stakeholder Collaboration & Requirement Gathering
- Engage with clients, internal teams, and leadership to understand business needs and translate them into technical requirements.
- Act as a bridge between IT, RCM, and operations teams to ensure seamless implementation of solutions.
- Document business processes, user requirements, and system functionalities for project execution.
Reporting & KPI Tracking
- Define and track key performance indicators (KPIs) related to AR days, denial rates, clean claim rates, collections, and compliance.
- Prepare quarterly business reviews (QBRs) and reports to support executive decision-making.
- Ensure data integrity, accuracy, and compliance with healthcare industry standards.
Qualifications & Skills
- Bachelor’s degree in Healthcare Administration, Business Analytics, Finance, or a related field (Master’s preferred).
- 5+ years of experience in healthcare business analysis, RCM, or financial analytics.
- Strong understanding of medical billing, coding (ICD-10, CPT, HCPCS), payer policies, and claims processing.
- Proficiency in RCM software, EHR/EMR systems (Epic, Meditech, Paragon), SQL, and BI tools (Power BI, Tableau, etc.).
- Experience in denial management, revenue forecasting, and financial modeling.
- Strong analytical, problem-solving, and communication skills.
- Ability to work in a fast-paced, cross-functional environment.
Why Join Plutus Health?
- Be part of a fast-growing, data-driven healthcare organization leading the industry in innovation.
- Work with a high-impact team that values collaboration, insights, and strategic decision-making.
- Competitive compensation, benefits, and professional growth opportunities.