Position Summary

The Associate Revenue Cycle Analyst – Insurance Verification serves as a subject matter expert and analytical resource within the Insurance Verification Team (IVT), with a focus on improving front-end revenue cycle performance and preventing eligibility-related claim rejections and denials.

This role combines strong revenue cycle knowledge with data analysis, problem solving, and project ownership to identify trends and root causes impacting insurance eligibility and claim accuracy. The Revenue Cycle Analyst will analyze operational and claims data, research payer requirements and policies, identify upstream and downstream impacts, and partner cross-functionally to implement sustainable solutions.

Successful candidates will be proactive, highly analytical, and comfortable independently investigating complex issues from initial identification through resolution. This role requires the ability to move beyond individual errors to understand broader patterns, determine the underlying cause, and develop solutions that improve workflows and prevent future revenue cycle issues.

Job Responsibilities

• Serve as a subject matter expert for insurance verification and front-end revenue cycle processes, including eligibility, patient insurance information, payer requirements, and factors impacting clean claim submission.
• Analyze eligibility-related rejections, claim data, and operational performance to identify trends, root causes, and opportunities for improvement.
• Investigate recurring eligibility issues by reviewing payer policies, EOBs, patient demographics, insurance information, and other relevant documentation and systems.
• Identify upstream process breakdowns that may result in claim rejections or downstream denials and develop recommendations to prevent recurrence.
• Evaluate the broader impact of identified issues to determine whether additional patients, claims, payers, workflows, or business processes may be affected.
• Use SQL and Snowflake to obtain and analyze data needed to investigate revenue cycle questions, validate trends, and measure performance.
• Utilize advanced Excel functionality, including pivot tables and lookup functions, to analyze large datasets, identify meaningful trends, and translate complex data into actionable insights.
• Develop reports, dashboards, automation, tracking tools, and other analytical resources that improve visibility into insurance verification performance and opportunities.
• Independently manage improvement initiatives from identification through implementation, including coordinating with cross-functional partners, tracking progress, testing solutions, validating resolution, and monitoring results after implementation.
• Partner with Billing Operations, Clean Claim, Coding, Prior Authorization, technology, vendor operations, and other teams to resolve issues affecting insurance verification and downstream revenue cycle performance.
• Develop or enhance workflows and SOPs to improve front-end accuracy, operational efficiency, and consistency.
• Monitor key performance indicators and operational trends to proactively identify emerging risks and improvement opportunities.
• Create and present detailed, executive-ready presentations that communicate trends, root causes, recommended solutions, project status, and upstream and downstream revenue cycle impacts.
• Translate complex analytical findings into clear, actionable information for both operational teams and leadership.
• Maintain knowledge of payer policies, billing requirements, and changes that may affect insurance verification or claim processing.
• Act as an educator and resource to operational teams regarding identified performance improvement opportunities, process changes, and best practices.
• Continuously identify opportunities to leverage data, technology, automation, and improved workflows to increase efficiency and prevent avoidable claim rejections and denials.

Qualifications

• Bachelor's degree in business, healthcare, analytics, or a related field preferred.
• 2–3+ years of experience in revenue cycle management, medical billing, insurance verification, claims operations, or a related healthcare function.
• Strong understanding of healthcare revenue cycle processes, including how patient and insurance information impacts claim creation, submission, acceptance, denials, and reimbursement.
• Experience researching insurance eligibility, payer requirements, EOBs, patient demographic information, or related front-end billing issues strongly preferred.
• Working knowledge of medical terminology and healthcare billing concepts, including CPT/HCPCS, ICD-10, modifiers, and payer requirements.
• Proficiency with Microsoft Excel, including pivot tables, lookup functions, data manipulation, and analysis of large datasets.
• Working knowledge of SQL and experience using a data warehouse or analytics platform such as Snowflake. Candidates should be able to independently obtain the data needed to answer business questions using SQL, including effectively leveraging AI-assisted query development when appropriate.
• Demonstrated ability to analyze data, recognize patterns, investigate root causes, and translate findings into actionable solutions.
• Strong project management and organizational skills with the ability to independently drive initiatives from identification through implementation and post-implementation monitoring.
• Strong written and verbal communication skills, including the ability to create polished presentations and communicate complex findings to leadership.
• Ability to work autonomously, manage competing priorities, and proactively identify next steps without significant direction.
• Strong critical-thinking, problem-solving, and solution-oriented mindset.
• Ability to quickly learn new revenue cycle processes, systems, technologies, and payer requirements.