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Revenue Cycle Operations Analyst

$85k - $95k

Clarvida Maine

Revenue Cycle Operations AnalystPosition at Clarvida - CaliforniaJob Title: Revenue Cycle Operations Analyst Location: California (Remote/Hybrid) Employment Type: Full-time Salary: $85,000 - $95,000 per year (dependent on experience, education, and market factors)About the RoleThe Revenue Cycle Operations Analyst supports California Operations by analyzing and improving front-end revenue cycle performance across multiple programs. This role serves as a subject matter expert in eligibility verification, payer requirements, authorization management, financial clearance, and billing readiness processes. Working closely with operational, clinical, and revenue cycle leadership, the Revenue Cycle Operations Analyst identifies opportunities for process improvement, reduces billing and compliance risks, and supports organizational performance through data-driven decision-making and operational excellence.Responsibilities· Analyze front-end revenue cycle workflows, eligibility verification processes, financial clearance activities, and billing readiness across multiple programs · Interpret Medi-Cal, Medi-Medi, commercial payer, authorization, Share of Cost, and eligibility requirements and provide operational guidance · Develop, implement, and maintain revenue cycle procedures, controls, and best practices that support compliant and efficient operations · Prioritize revenue cycle issues, identify risks, and coordinate corrective actions with operational and revenue cycle leadership · Review billing errors, financial clearance trends, and workflow exceptions to identify root causes and improvement opportunities · Recommend and monitor corrective action plans to improve claim readiness and reduce denial risks · Develop and maintain key performance indicators (KPIs), dashboards, scorecards, and operational reports · Analyze operational and financial data to identify trends, forecast risks, and support performance improvement initiatives · Present findings, recommendations, and action plans to leadership and stakeholders · Design and deliver training related to payer requirements, eligibility processes, financial clearance, and billing readiness standards · Provide subject matter expertise on EHR and billing platforms, including IRIS, Avatar, or similar systems · Collaborate with clinical, operational, billing, and leadership teams to improve workflows and support organizational goals · Participate in county, operational, revenue cycle, and cross-functional meetings as needed · Support contract compliance, reporting requirements, audits, and operational initiatives · Perform additional duties as assignedRequired Qualifications· Bachelor's degree in Healthcare Administration, Business Administration, Finance, Accounting, Analytics, Public Health, or a related field, or an equivalent combination of education and directly related experience · Minimum three years of revenue cycle, billing operations, financial clearance, healthcare operations, payer operations, or related analytical experience · Experience interpreting Medi-Cal, Medi-Medi, commercial payer, eligibility, authorization, Share of Cost, and claim readiness requirements · Experience analyzing operational data and developing reports, dashboards, and performance metrics · Experience with EHR and billing platforms such as IRIS, Avatar, or similar systems · Advanced proficiency in Microsoft Excel and reporting tools · Strong analytical, critical thinking, and problem-solving skills · Ability to exercise independent judgment and make recommendations regarding complex operational issuesPreferred Qualifications· Experience supporting multiple programs, regions, or business units · Experience with healthcare KPI reporting, dashboard development, business intelligence, or data visualization tools · Knowledge of County behavioral health systems, public behavioral health funding structures, and payer contracts · Experience leading process improvement initiatives, workflow redesign, or cross-functional projects · CRCR, CHAA, HFMA, Lean Six Sigma, or related certification preferredCompensation & BenefitsFull-time Employees: · Paid vacation days (increase with tenure) · Separate sick leave that rolls over annually · Paid holidays · Medical, dental, and vision insurance options · DailyPay – access your earnings without waiting for payday · Training, development, and professional growth opportunities All Employees: · 401(k) · Employee Assistance Program (EAP) · Pet insurance · Perks @ Clarvida – national discounts on shopping, travel, Verizon, and entertainment (Benefits may vary by state or county)Work Location California – Remote/Hybrid Travel required up to approximately 30% for meetings, training, program support, and operational initiativesEmployment Type Full-timeHow to Apply If you are passionate about revenue cycle operations, healthcare analytics, process improvement, and driving operational excellence, click "Apply Now" to join Clarvida as a Revenue Cycle Operations Analyst.About Clarvida Clarvida is a leader in behavioral health care, providing community-based mental health and human services. The organization is committed to delivering innovative care while fostering a supportive and growth-oriented environment for employees.Equal Opportunity Employer Clarvida is an equal opportunity employer committed to diversity and inclusion. All qualified applicants will receive consideration without regard to race, color, religion, gender, national origin, age, sexual orientation, gender identity, disability, veteran status, or any other protected characteristic.Fraud Alert Clarvida never charges fees to apply. Official communication regarding job opportunities will only come from authorized @clarvida.com email addresses, View email address on click.appcast.io, or verified LinkedIn profiles associated with Clarvida email accounts.Keywords Revenue Cycle Operations Analyst, Revenue Cycle Analyst, Healthcare Operations, Billing Operations, Financial Clearance, Eligibility Verification, Medi-Cal, Revenue Integrity, Healthcare Analytics, Business Intelligence, Healthcare Administration, Behavioral Health Operations, Clarvida Careers

Vacancy posted 3 days ago
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