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

• Perform pricing and transparency reporting functions to support compliance with Blue Cross Association and federal mandates
• Provide members with cost information for common medical procedures, surgeries, treatments, and quality-of-care information
• Support facility and professional reimbursement areas through implementation of processes, procedures, reports, software, and operational refinements
• Collaborate with cross-divisional business areas, IT, and vendors to improve reimbursement operations and solve organizational information challenges
• Build an efficient, effective, and compliant technical analytical reporting infrastructure
• Refine, implement, automate, and manage the reimbursement operations strategy with senior team members and the Manager, Healthcare Price and Transparency
• Design, configure, implement, maintain, and document transparency cost algorithms for internal and external transparency initiatives
• Assess reimbursement operations, determine business requirements, identify improvement opportunities, and assist with business and technology systems design
• Recommend business process improvements, system testing, controls, and protocols
• Perform data transformation, data validation, reporting, and analytics

Healthcare Price & Transparency Analyst

• Handle administrative and medical appeals requiring clinical input or interpretation
• Direct and coordinate all aspects of denied claims
• Coordinate comprehensive clinical documentation to third-party payers and state agencies to secure accurate payment
• Identify coding or clinical documentation issues
• Provide ongoing trend analysis to identify reasons for denials and apply corrective action steps
• Research and understand payer issues
• Troubleshoot and resolve issues impacting revenue
• Facilitate the internal appeal process
• Work through denied claims, gather information, and take appropriate action to ensure proper adjudication
• Utilize equipment, supplies, facilities, and resources prudently and efficiently
• Perform other duties as assigned or requested

Analyst jobs in Louisiana

Senior Analyst, RCM Data – Technology

Healthcare Price & Transparency Analyst

Denial Analyst – RN