POSITION SUMMARY
The Hospital Revenue Cycle Specialist - Data Analyst & Project Manager is responsible for leading cross-functional revenue cycle projects and providing advanced analytical support to improve financial performance, compliance, and operational efficiency. This role blends high-level data analysis with hands-on project management to drive improvement across scheduling, registration, authorization, coding, billing, revenue integrity, and clinical workflows.
This position has a dotted-line reporting relationship to the Information Technology Director to ensure alignment with system architecture, data governance, and integration efforts. The Analyst also works closely with the Accounting Analyst to provide financial reporting integrity, reconciliation accuracy, and consistent data interpretation across finance and revenue cycle functions.
ESSENTIAL JOB FUNCTIONS (including, but not limited to)
Data Analytics & Reporting
- Analyze revenue cycle KPIs, including AR days, DNFB, denial trends, charge lag, reimbursement variances, and operational bottlenecks.
- Develop recurring dashboards and ad-hoc reports using Excel, SQL, or similar tools.
- Monitor payer contract performance and expected reimbursement.
- Validate data sources to ensure accuracy and consistency across systems.
Project Management & Leadership
- Lead medium- and large-scale revenue cycle projects across hospital departments.
- Develop project plans, timelines, and charters; track milestones and ensure accountability.
- Facilitate meetings, drive communication, and remove barriers to project progression.
- Assist in identifying and vetting vendors for revenue cycle optimization
- Conduct current-state workflow assessments and design optimized future-state workflows.
- Support system upgrades, workflow enhancements, and technology implementations.
- Coordinate testing, validation, and adoption of new processes in Meditech Expanse, FinThrive, Experian, and related systems.
Denials, Revenue Integrity & Compliance
- Identify root causes of denials and develop corrective action strategies.
- Support internal and external audits, including DRG downgrades, clinical validation appeals, and documentation reviews.
- Monitor coding accuracy, documentation completeness, and charge capture processes.
- Stay current on CMS regulatory changes and payer billing requirements.
Cross Department Collaboration
- Work with Patient Access, Coding/HIM, Business Office, Case Management, IT, and clinical departments