Revenue Operations Analyst

This is a fully remote position, open to applicants in California.

📋 Description

• Oversee the daily functions of denials management, appeals, self-pay inventory, claims write-offs, client edits, client portal usage, payer policy modifications, AR aging across various payer categories, insurance eligibility, and trends in insurance discovery.

• Supervise, uphold, and convey denials and appeals activities to clients and internal stakeholders.

• Offer guidance and direction to the team to ensure that goals for total AR collections, credit balances, edits, and denials are met or surpassed.

• Detect emerging patterns in claims payments and evaluate expected versus actual reimbursements.

• Confirm that all activities are in compliance with Cottage Health and PDL policies, procedures, as well as federal and state regulations.

• Assist in recruitment, retention, training, and allocation of work.

⛳️ Requirements

• Bachelor’s degree or equivalent experience in Lab RCM with a minimum of 6 years.

• At least five years of LAB RCM experience, ideally in a multi-facility setting.

• Minimum of three years in progressively responsible roles within the healthcare revenue cycle.

• Knowledge of ICD-10 coding for laboratory CPTs.

• Familiarity with payer denials and the appeals process.

• Proficient in healthcare insurance eligibility, verification, and claims submission procedures.

• Skilled in utilizing software applications to enhance automation and operational efficiency in a business office context.

• Competent in Microsoft Office, particularly Excel and PowerPoint.

• Ability to analyze data to identify trends and opportunities for process improvement.

• Experience with legal consent policies and procedures, as well as payer contracting and policies.

• Understanding of medical terminology.

• Experience with MS-Office 365 is preferred.

🏝️ Benefits

• Eligible employees may receive shift differentials, on-call pay, incentive pay, and bonus opportunities, where applicable.

• Managerial roles and above may take part in Cottage Health’s annual management incentive program.

• Comprehensive Total Rewards offerings.