RCM Analyst

Role Overview:

The RCM Analyst supports the Revenue Cycle Management department through reporting, data analysis, and business intelligence activities, with primary responsibility for analytical support of the RCM Intelligence and Payor Relations functions. The RCM Analyst is expected to deliver accurate, timely, and actionable reporting and analysis that improves visibility into payor, credentialing, and revenue cycle performance.

The Analyst will identify meaningful trends and potential issues, support leadership decision-making with reliable data, maintain strong data integrity, and contribute to improvements in reporting efficiency and operational processes. This role requires solid technical skills in data analysis, database querying, and business intelligence tools. Healthcare and insurance knowledge is not a prerequisite, the RCM Intelligence Manager will provide domain training, but strong technical capability is required from day one.

• Develop, maintain, and enhance recurring reports, dashboards, scorecards, and ad hoc analyses supporting RCM operations.
• Collect, validate, organize, and analyze data from practice management systems, billing platforms, payor portals, credentialing systems, contract databases, and other data sources.
• Identify trends, variances, anomalies, and opportunities for improvement within operational and financial data.
• Support the development and monitoring of key performance indicators and provide timely reporting to leadership and business stakeholders.
• Perform data validation and reconciliation to ensure reporting accuracy, consistency, and integrity.
• Assist with automating recurring reports and improving reporting processes to reduce manual effort.
• Translate analytical findings into clear summaries, visualizations, and actionable insights for non-technical stakeholders.
• Participate in projects involving data integration, reporting improvements, system enhancements, and operational optimization.

• Analyze payor performance, reimbursement trends, negotiated rates, underpayments, denials, and reimbursement variances.
• Develop and maintain reporting processes to monitor negotiated reimbursement rates and payor compliance.
• Support benchmarking of reimbursement across commercial insurance, Medicare Advantage, Medicaid, and other payor arrangements.
• Assist with financial analysis related to payor contract negotiations, renewals, rate changes, and proposed contract terms.
• Maintain and update contract and reimbursement information within internal databases and reporting tools.
• Develop analyses and models to quantify the potential financial impact of reimbursement changes and other payor-related initiatives.
• Assist with identifying and escalating trends that may negatively impact reimbursement, collections, or overall revenue cycle performance.
• Support analysis of insurance contracts and reimbursement structures for existing and prospective practices.
• Credentialing Analytics Support
• Develop and maintain reporting related to provider credentialing, enrollment, participation, and related operational activities.
• Track and report on credentialing status, enrollment progress, aging, expirations, turnaround times, and outstanding requirements.
• Identify trends, bottlenecks, and opportunities to improve credentialing workflows and operational visibility.
• Support data reconciliation and validation between credentialing records, provider information, payor data, and other relevant systems.
• Maintain accurate and well‑documented datasets related to providers, locations, payors, participation status, and credentialing activities.

• Bachelor’s degree in Data Analytics, Business Analytics, Computer Science, Statistics, Information Systems, or a related technical field preferred.
• 2 to 4 years of experience in data analysis, business intelligence, reporting, or related field.
• Demonstrated experience building reports and dashboards in Power BI or a comparable business intelligence platform required.
• Experience writing SQL queries to extract, transform, and analyze data from relational databases…