RCM Analyst

You are applying for a position through Medix, a staffing agency. The actual posting represents a position at one of our clients.


Job Summary


Our client is seeking a proficient Systems Analyst responsible for conducting comprehensive denial claim analysis, improving workflows, and developing standardized denial analysis procedures. The goal is to enhance operational efficiency and support internal stakeholders with clear, concise reporting.


Key Responsibilities

• Conduct comprehensive analysis of denied claims to determine root causes and contributing factors.
• Review and interpret CARC (Claim Adjustment Reason Codes) and RARC (Remittance Advice Remark Codes).
• Analyze ERA/835 files, EOBs, payer responses, and claim documentation to identify denial drivers.
• Determine whether denials are related to authorization issues, coding errors, billing errors, front-end intake failures, payer-specific requirements, or other factors.
• Develop and document standardized denial analysis workflows, procedures, and best practices.
• Create and maintain SOPs for repeatable denial review and investigation processes.
• Define data requirements and documentation standards for denial categorization and reporting.
• Identify recurring denial patterns and opportunities for operational improvement and automation.
• Partner with operational, product, and cross-functional teams to translate findings into workflow enhancements and scalable solutions.
• Prepare clear, concise summaries and reports for internal stakeholders and customers.

Qualifications

• 3+ years of experience in Revenue Cycle Management (RCM), denial management, medical billing, or related healthcare reimbursement functions.
• Direct experience performing claim-level denial investigations and root cause analysis.
• Strong knowledge of CARC and RARC codes.
• Experience reviewing and interpreting ERA/835 files and Explanation of Benefits (EOBs).
• Familiarity with healthcare billing systems and EMRs; Brightree experience is highly preferred.
• Strong understanding of payer reimbursement processes and denial management workflows.
• Ability to distinguish between preventable denials, appealable denials, and payer-driven denials that cannot be addressed through operational changes.
• Excellent analytical, documentation, and written communication skills.
• Ability to present findings to both technical and non-technical audiences.

Additional Requirements


The position operates on a Monday through Friday schedule from 9 AM to 6 PM.


Benefits

• Paid Sick Leave (Medix provides paid sick leave according to state and local sick leave ordinances).
• Health Benefits / Dental / Vision (Medix offers 6 different health plans: 3 Major Medical Plans, 2 Fixed Indemnity Plans (Standard and Preferred), and 1 Minimum Essential Coverage (MEC) Plan. Eligibility for health benefits is based on verifying that an average of 30 hours per week during the first 4 weeks of the work assignment has been met. If you meet eligibility requirements and take action to enroll, you will be covered no earlier than 60 days into your assignment, depending on plan selection(s)).
• 401k (Eligible on the first 401k open enrollment date following 6 consecutive months on assignment. 401k Open Enrollment dates are 1/1, 4/1, 7/1, and 10/1).
• Short Term Disability Insurance.
• Term Life Insurance Plan.

* We will consider for employment all qualified Applicants, including those with criminal histories, in a manner consistent with the requirements of applicable federal, state, and local laws, including the City of Los Angeles' Fair Chance Initiative for Hiring Ordinance (FCIHO), Los Angeles Fair Chance Ordinance for Employers (ULAC), The San Francisco Fair Chance Ordinance (FCO), and the California Fair Chance Act (CFCA).


Medix Overview:


With over 20 years of experience connecting organizations with highly qualified professionals, Medix is a leading provider of workforce solutions for clients and candidates across the healthcare, scientific, technology, and government industries. Through our core purpose of positively impacting lives, we're dedicated to creating opportunities for job seekers at some of the nation's top companies. As an award-winning career partner, Medix is committed to helping talent find fulfilling and meaningful work because our mission is to help you achieve yours.


* As a job position within our Revenue Cycle division, a successful completion of a background check may be required as a condition of employment. This requirement is directly related to essential job functions including but not limited to: accessing financial and confidential information, handling financial and other payment data, and working within departments that care for vulnerable populations, such as, minors, elderly and those with physical or mental disabilities. Due to these job duties, this position has a significant impact on the business operations and reputation, as well as the safety and well-being of individuals who may be cared for as part of the job position or who may interact with staff or clients.