Core Health LLC

Analyst

• Analyze, optimize, and maintain data, technology, and reporting processes supporting Revenue Cycle Management operations
• Ensure completeness, accuracy, timeliness, and integrity of clinical and financial data across the revenue cycle ecosystem
• Partner with Revenue Cycle Operations, IT, Coding, Billing, Provider Enrollment, hospital partners, and external technology vendors
• Identify data integrity issues and monitor system interfaces and chart acquisition
• Develop reconciliation, exception, executive, operational, and RCM performance reporting
• Develop, enhance, and support RCM data warehouse processes, reporting, chart integrity databases, payer connectivity, system integrations, and automated monitoring
• Monitor data flows across hospital EMRs/EHRs, coding platforms, clearinghouses, payer systems, provider enrollment systems, financial reporting platforms, and other RCM applications
• Resolve missing, duplicate, delayed, incomplete, or inaccurate clinical and financial data
• Maintain encounter-to-billing reconciliations and identify revenue-cycle gaps
• Maintain and enhance the Chart Integrity Database and reporting
• Automate exception monitoring for acquisition, interface, workflow, data, and revenue issues
• Analyze RCM trends to identify operational and financial opportunities
• Develop, test, implement, and optimize HL7, API, EDI, and other RCM interfaces
• Partner with IT, vendors, and hospitals to resolve interface and data issues
• Support payer connectivity and automation for eligibility, authorization, claims, disputes, and related functions
• Develop and monitor KPIs for chart integrity, encounter reconciliation, coding, claims, payer connectivity, data quality, revenue leakage, and system performance
• Translate business needs into reporting, analytics, automation, and technology solutions
• Support system implementations, upgrades, testing, workflow changes, and enhancements
• Document requirements, workflows, test plans, and implementations
• Coordinate data validation, troubleshooting, and sustainable solutions with teams and vendors
• Maintain hospital contacts, RCM system access, and data availability
• Plan projects, set milestones, track deliverables, and report status
• Automate manual processes to improve scalability, data quality, and efficiency
• Provide analytical and technical support for strategic RCM initiatives and growth
• Advise operational, financial, clinical, and technology stakeholders on RCM data and technology

Senior Analyst, RCM Data – Technology

Compliance

• Extract clinical information from electronic medical record systems
• Analyze medical documentation and ensure proper CPT billing selection using CMS coding guidelines
• Review medical records for inconsistent documentation practices and offer remediation solutions
• Provide ongoing outreach and education to new and existing coders on Emergency Medicine and Hospital Medicine coding and documentation requirements
• Assign appropriate ICD-10, CPT, and HCPCS codes to diagnoses, procedures, and services
• Validate code accuracy and adherence to coding guidelines and regulations
• Maintain current knowledge of coding standards, regulations, and payer policies
• Meet quality and productivity goals set by the Coding Manager
• Ensure compliance with federal, state, and payer-specific coding requirements
• Review coding discrepancies and provide feedback to the coding leadership team
• Conduct audits of coded records
• Recommend coding improvements and best practices
• Review new business medical records for documentation opportunities and templating education
• Use coding software and EHR systems
• Stay informed about coding system and software updates
• Serve as an expert resource for coding and documentation requirements
• Perform other related duties as assigned

Coding Compliance Specialist

• Provide advanced analytical support for clinical, operational, and performance data
• Translate complex data into insights informing operational strategy, quality improvement, and leadership decisions
• Evaluate data integrity, interpret performance trends, identify root causes of reporting variances, and recommend solutions
• Serve as a subject matter resource for hospital data, metric definitions, validation methodology, and dashboard interpretation
• Evaluate accuracy, completeness, and consistency of clinical and operational performance data
• Investigate discrepancies, missing information, and unexpected performance trends; recommend corrective actions
• Develop and maintain metric definitions, data dictionaries, validation processes, and documentation standards
• Lead recurring reporting and analytics audits and quality assurance reviews
• Manage collection, interpretation, and maintenance of hospital-partner operational and clinical data
• Reconcile hospital-supplied data with internal reporting and recommend process or methodology improvements
• Guide data readiness activities for new hospital partnerships
• Assess reports and dashboards for accuracy, consistency, usability, and operational alignment
• Analyze trends, outliers, risk areas, and improvement opportunities and communicate actionable insights
• Develop clinical ad hoc analyses and reporting deliverables
• Document reporting processes, methodologies, assumptions, and metric logic
• Assess dashboard design, define user needs, recommend enhancements, and support adoption of performance tools
• Design and enhance scorecards, dashboards, and reports
• Partner with Clinical Optimization, Operations, and IT teams on data quality and reporting issues
• Coordinate testing and implementation of reporting enhancements and new data sources
• Represent operational reporting needs in cross-functional discussions

Senior Analyst, RCM Data – Technology

Coding Compliance Specialist

Clinical Data Performance Analyst