Revenue Cycle Policy & Quality Analyst

JOB SUMMARY

Responsible for analyzing and monitoring revenue cycle policies and quality standards to ensure compliance, efficiency, and accuracy. Provides expertise in policy review, quality audits, and process reporting to support operational effectiveness. Ensures alignment of revenue cycle activities with regulatory requirements, payer contracts, and organizational policies. Develops audit findings and recommendations to strengthen performance and compliance. Coordinates collaboration with revenue cycle leaders and compliance teams to address risks and optimize workflows.

• Reviews and analyzes revenue cycle policies, procedures, and workflows to ensure compliance with organizational and regulatory standards.
• Conducts quality audits of billing, claims, and payment processes to identify errors, risks, and improvement opportunities.
• Tracks and reports policy compliance metrics, presenting findings to leadership with recommendations.
• Collaborates with compliance, internal audit, and revenue cycle leadership to address gaps in processes and documentation.
• Develops, maintains, and distributes policies and guidelines to support consistent revenue cycle practices.
• Monitors payer requirements, regulatory updates, and industry trends to update policies and procedures.
• Participates in process improvement initiatives to enhance billing accuracy, reduce denials, and improve patient financial outcomes.
• Performs other duties as assigned.

• Minimum requirement:
  • Bachelor’s degree
  • 2+ years of experience
  • An equivalent combination of education and experience may be considered. All experience must be paid and in the same related field. Part‑time and PRN experience will be prorated based on hours worked per week. Volunteer work and internships for academic credit are not counted.
• Preferred qualifications:

• Works indoors in an office/clinic setting
• The noise level is usually moderate

• Constantly required to maintain a stationary position behind a computer.
• Frequently required to move about inside the department.
• Constantly required to communicate telephonically and face to face with colleagues and customers.
• Constantly required to operate a computer and telephone.
• Constantly required to lift and/or move up to 10 pounds.
• Frequently required to lift and/or move up to 25 pounds.
• Occasionally required to lift and/or move up to 50 pounds.
• Specific vision abilities required by this job include close vision, distance vision, color vision, peripheral vision, and depth perception.