Revenue Cycle Analyst

Job Summary: 

The RCM Analyst supports revenue cycle operations with a focus on financial reconciliation, system accuracy, account resolution, RCM reporting, and technical process improvement. This role independently researches financial activity across bank records, the RCM billing & reporting system [Lightning Step (LS)], payer portals, and internal reporting to ensure deposits are verified, claim transactions are accurately recorded, and outstanding transactions are resolved or escalated.

The ideal candidate has advanced Excel skills, strong technical aptitude, and the ability to work confidently with large data sets and multiple systems. The role requires attention to detail, sound judgment, ownership of recurring workflows, and clear communication of discrepancies, trends, and recommended next steps.

 

Responsibilities  

Daily Deposit Reconciliation & Payment Accuracy

• Partner with the RCM Manager and Senior Director of Revenue Cycle on reconciliation priorities, research findings, unresolved variances, and process improvements. Provide timely updates and escalate issues requiring review or approval.
• Complete daily deposit reconciliation which requires comparison of bank deposit activity with transactions recorded in LS; deposit date verification/correction; upload of supporting EOBs and documentation.
• Perform month-end reconciliation of monthly deposits, investigate variances, document status and resolution of outstanding discrepancies.
• Review and resolve unallocated insurance and private pay payments, requires analysis of bank and LS activity, research of the related LS accounts then determination of appropriate application action/entry.
• Review and resolve unallocated client activity and client credit-balance; requires analysis of bank and LS activity, identification of root causes and coordination of corrections in accordance with approval requirements.
• Review and manage paid to subscriber (PTS) outstanding balances using existing reporting, update accounts once deposits are confirmed and confirm payment posting is complete and accurate.
• Review and reconcile private pay collection partner reporting, Capital Recovery (CR), post private pay deposits as appropriate, and investigate discrepancies between CR reporting, bank activity, and LS account balances.

Payment Posting, Adjustments & Account Resolution

• Work with the RCM Manager and Senior Director of Revenue Cycle to review account-resolution findings, determine appropriate next steps, and escalate adjustments, write-offs, or other changes requiring approval
• Research incorrect postings, reversals, contractual adjustments, and CO-45 adjustments; determine cause of discrepancies and coordinate accurate corrections.
• Review credit balances, canceled accounts, crossed-account payments, and other account variances to identify appropriate resolution and prevent recurring issues.
• Review aged private-pay balances, prioritizing accounts +2 years then shift attention to accounts 1-2 year age; research account history, recommend appropriate next steps.
• Review closed CR accounts, identify items for potential write-off or adjustment, following established approval processes before changes are finalized.
• Validate vendor collection activity, fees against reported collections and actual cash received; research differences and communicate findings to internal leadership and vendor contacts.

EOB Visibility & Cross-Team Support

• Coordinate with the RCM Manager and Senior Director of Revenue Cycle, along with payment posting and other internal teams, to address documentation gaps, communicate outstanding items, and improve cross-team visibility and follow-up.
• Review payer portals for $0-payment EOBs, download supporting documents, upload to LS or designated location.
• Send $0-payment EOBs to payment posting team and maintain visibility so relevant teams can take timely action.
• Maintain clear documentation of research performed, discrepancies identified, actions taken, open items, and required follow-up.

Advanced Excel, Systems & Technical Process Improvement

• • Use advanced Excel capabilities to analyze, reconcile, and validate large data sets, including formulas and lookup functions, SUMIFS, pivot tables, filtering, conditional formatting, and data comparison techniques.
  • Build and maintain reconciliation workbooks, trackers, and reports that improve visibility into deposits, unallocated payments, PTS activity, credit balances, EOBs, and CR posting.
  • Identify data-quality issues, reporting gaps, workflow inefficiencies, and opportunities to reduce manual work; recommend practical system or process improvements.
  • Navigate LS, payer portals, banking records, and internal reporting tools efficiently; troubleshoot discrepancies across systems and trace transactions from source documentation through account posting.
  • Summarize findings in clear, actionable format, including amount and type of variance, affected account or transaction, likely cause, corrective action, owner, and follow-up date.

Requirements  
 

• Bachelor’s degree strongly preferred in Business, Accounting, Finance or a related field.
• Minimum 3 years’ experience in revenue cycle management, patient financial services, medical billing, or related financial operations within healthcare environments.
• Payor Knowledge: Knowledge of healthcare payors, payer portals, EOBs, claim payment outcomes, contractual adjustments, denials, and payment discrepancies.
• Accounts Receivable (AR) Follow-Up: Knowledge of researching unpaid and underpaid claims, reviewing account history, documenting payer interactions, tracking follow-up actions, and escalating unresolved issues.
• Advanced Excel: Proficiency with formulas, lookup functions, SUMIFS, pivot tables, conditional formatting, and reconciling large data sets.
• Technical Capabilities: Ability to navigate multiple systems, payer portals, financial records, and reporting tools while independently investigating discrepancies.
• Analytical Skills: Ability to validate data, identify root causes, recommend corrections, and communicate findings clearly.
• Organization and Communication: Strong attention to detail, time management, follow-through, and written and verbal communication skills.

 

 

This is a hybrid position requiring two days in-office at our Los Angeles corporate office