revenue cycle analyst

Cedars-Sinai Medical Center

<p></p><div><div><div><div><p><b>Job ID</b> 16108</p>
<p><b>Location</b> Torrance, California, United States
</p><p><b>Job Category</b> Patient Financial Services
</p><p><b>Date posted</b> 04/11/2026</p></div></div><p></p><div><br>
<div></div>
</div></div><div><h2 class="jobSectionHeader"><b>Job Description</b></h2><p>
Align yourself with an organization that has a reputation for excellence! Cedars Sinai was awarded the National Research Corporation&rsquo;s Consumer Choice Award 19 years in a row for providing the highest-quality medical care in Los Angeles. We also were awarded the Advisory Board Company&rsquo;s Workplace of the Year. This annual award recognizes hospitals and health systems nationwide that have outstanding levels of employee engagement. We provide an outstanding benefit package that includes health care, paid time off and a 403(B). Join us! Discover why U.S. News &amp; World Report has named us one of America&rsquo;s Best Hospitals.</p><p><b>
What will I be doing in this role?</b></p><p>
The Revenue Cycle Analyst is responsible for the development, assessment and quantification of trends. This will require direct working relationships with management and key staff members, in addition to key members of Finance and Medical Network and Medical Center Departments. The primary duties of this role include:</p><ul><li>
Analyzing trends to determine where variances are occurring and develop reports to assess these variances.</li><li>
Summarizing information, data, and recommendations, and preparing presentation materials. May present findings to management.</li><li>
Making recommendations based upon overall analysis to effectively monitor areas of opportunity/risk.</li><li>
Creating/developing regular and ad-hoc reports.</li><li>
Payor Policy analysis and review.</li><li>
Denial and Revenue Cycle trending.</li><li>
Using independent judgment to resolve issues.</li><li>
Completing complex/special assignments.</li></ul><h2 class="jobSectionHeader"><b>
Qualifications</b></h2><p><b>
Requirements:</b></p><ul><li>
High School Diploma or GED required. Bachelor's degree in finance, economics, business or a related field preferred.</li><li>
A minimum of 1 year of proven experience as an analyst (revenue cycle, data, financial, business, or related) preferred.</li><li>
A minimum of 3 years of proven experience in billing and collections revenue cycle experience required.</li><li>
Experience in Healthcare delivery systems with knowledge of CPT/HCPC, ICD-10 coding, clearinghouse, EDI claims and remittance advice processing, and Epic Revenue Cycle Applications (i.e. ADT/Prelude, Cadence, Resolute PB or HB) highly preferred.</li></ul><p><b><br>
Why work here?</b></p><p><br>
We take pride in hiring the best employees. Our dedicated staff reflects the culturally and ethnically diverse community we serve. They are proof of our dedication to creating a dynamic, inclusive environment that fuels innovation and the gold standard of patient care we strive for.</p>
</div><div><div><div><b>Req ID</b> 16108</div>
</div><div><div><b>Working Title</b> Revenue Cycle Analyst (Remote)</div>
</div><div><div><b>Department</b> CSRC PB - Group 3 CSMCF</div>
</div><div><div><b>Business Entity</b> Cedars-Sinai Medical Center</div>
</div><div><div><b>Job Category</b> Patient Financial Services</div>
</div><div><div><b>Job Specialty</b> Revenue Integrity</div>
</div><p></p><div><div><b>Overtime Status</b> EXEMPT</div>
</div><div><div><b>Primary Shift</b> Day</div>
</div><div><div><b>Shift Duration</b> 8 hour</div>
</div><div><div><b>Base Pay</b> $77,022.40 - $119,392.00</div></div></div></div><p></p>
<br><div><div><h3 class="jobSectionHeader"><b>Diversity and Inclusion at Cedars-Sinai</b></h3>
<div>
We are caretakers and innovators committed to the pursuit of equitable healthcare. But health equity is not possible without representation. Our commitment to diversity goes beyond demographics or checking boxes. Our people must reflect the diverse identities, experiences and geographies of the communities and patients we serve &ndash; because that&rsquo;s what our patients, colleagues and communities deserve <b>Quality Care and Research&mdash;For All, By All</b>.</div>
</div><div><h3 class="jobSectionHeader"><b>Our compensation philosophy</b></h3>
<div>We offer a competitive compensation package for our employees. The base pay range shown generally applies to the greater Los Angeles area and may vary based on work location. Our range takes into account the wide range of factors that are considered in making compensation decisions, including knowledge/skills: relevant experience and training, education/certifications/licensure; and other business and organizational factors. The base pay range does not include any incentive payments that may be applicable to a role. <b>Pay Transparency Non-Discrimination Provision (PDF) </b>.
</div></div><div><h3 class="jobSectionHeader"><b>Cedars-Sinai is an Equal Employment Opportunity employer.</b></h3>
<p>
Cedars-Sinai does not unlawfully discriminate on the basis of the race, religion, color, national origin, citizenship, ancestry, physical or mental disability, legally protected medical condition (cancer-related or genetic characteristics or any genetic information), marital status, sex, gender, sexual orientation, gender identity, gender expression, pregnancy, age (40 or older), military and/or veteran status or any other basis protected by federal or state law. If you need a reasonable accommodation for any part of the employment process, please contact us by email at <b>Applicant_Accommodation@cshs.org</b> and let us know the nature of your request and your contact information. Requests for accommodation will be considered on a case-by-case basis. Please note that only inquiries concerning a request for reasonable accommodation will be responded to from this email address.</p>
<p>
Cedars-Sinai will consider for employment qualified applicants with criminal histories, in accordance with the Los Angeles Fair Chance Initiative for Hiring.</p>
<p>
At Cedars-Sinai, we are dedicated to the safety, health and wellbeing of our patients and employees. This includes protecting our patients from communicable diseases, such as influenza (flu). For this reason, we require that all new employees receive a flu vaccine based on the seasonal availability of flu vaccine (typically during September through April each year) as a condition of employment, and annually thereafter as a condition of continued employment, subject to medical exemption or religious accommodation. For the same reason, you may also be required to receive other vaccines as a condition of employment. Cedars-Sinai reserves the right to make modifications to its required list of vaccines as required by law and/or policy.</p></div></div><div></div>

Revenue Cycle Analyst (Remote)

Seattle Children's

<div><p>The Revenue Cycle Analyst supports Seattle Children's ability to compliantly collect maximum reimbursement by analyzing and addressing internal and external charge, authorization, billing or payment issues resulting in delayed or denied payment. This role collaborates with all levels of staff in the Revenue Cycle, Contracting, IS and, Business Ops Analytics and Clinical teams. Gathering information using standard analytical tools, as well as information or escalations from leaders and front line staff, payer communications and internal account reviews, the Revenue Cycle Analyst identifies trends where outcomes differ from what is expected, then proactively recommends or initiates countermeasures within their operational team(s).</p><p><br>
</p><h2 class="jobSectionHeader"><b>This is a hybrid remote position and must be based in Washington state.</b></h2><p><b>
Required Education and Experience</b><br>
High school diploma or equivalent experience.<br>
Minimum three (3) years of relevant revenue cycle workflow experience resulting in technical understanding of CMS/Medicaid regulations and/or commercial payor billing or prior authorization requirements, and ability to accurately interpret related information; and,<br>
Experience or demonstrated aptitude with data analysis for the purpose of identifying unwanted variance and implementing change/improvement.<br>
<br>
<b>Required Credentials</b><br>
N/A.<br>
<br>
<b>Preferred</b><br>
Associate's degree or higher, or the equivalent post-secondary education and relevant business experience.<br>
Greater than three (3) years of relevant revenue cycle workflow experience resulting in technical understanding of CMS/Medicaid regulations and/or Commercial Payor billing, referral and/or prior authorization requirements and ability to accurately interpret related information; and,<br>
Experience implementing process improvement in healthcare revenue cycle operations.</p><p></p><p><b>
Compensation Range</b></p>
$60,643.00 - $90,965.00 per year<p></p><p><b>
Salary Information</b></p><p>
This compensation range was calculated based on full-time employment (2080 hours worked per calendar year). Offers are determined by multiple factors including equity, skills, experience, and expertise, and may vary within the range provided.</p><p></p><div><p><b>
Disclaimer for Out of State Applicants</b></p><p>
This compensation range is specific to Seattle, positions located outside of Seattle may be compensated differently depending on various factors<b>.</b></p><p></p><div><p><b>
Benefits Information</b></p><p>
Seattle Children&rsquo;s offers a generous benefit package, including medical, dental, and vision plans, 403(b), life insurance, paid time off, tuition reimbursement, and more. Additional details on our benefits can be found on our website www.seattlechildrens.org/careers/benefits.</p><p></p><div><p><b>
About Us</b></p><p><b>
Hope. Care. Cure. These three simple words capture what we do at Seattle Children&rsquo;s &ndash; to help every child live the healthiest and most fulfilling life possible. Are you ready to engage with a mission-driven organization that is life-changing to many, and touches the hearts of all? #HOPECARECURE</b></p><p></p><p>
Our founding promise to the community is as valid today as it was over a century ago: we will care for all children in our region, regardless of the families&rsquo; ability to pay. Together, we deliver superior patient care, advance new discoveries and treatments through pediatric research, and serve as the pediatric and adolescent, academic medical center for Washington, Alaska, Montana and Idaho &ndash; the largest region of any children&rsquo;s hospital in the country.<br>
<br>
U.S. News &amp; World Report consistently ranks Seattle Children&rsquo;s among the nation&rsquo;s best children&rsquo;s hospitals. For more than a decade, Seattle Children&rsquo;s has been nationally recognized in key specialty areas. We are honored to be one of the nation&rsquo;s very best places to care for children and the top-ranked pediatric hospital in Washington and the Pacific Northwest.</p><p></p><p>
As a Magnet designated institution, we recognize the importance of hiring and developing great talent to provide best-in-class care to the patients and families we serve. Our organizational DNA takes form in our core values: Compassion, Excellence, Integrity, Collaboration, Equity and Innovation. Whether it&rsquo;s delivering frontline care to our patients in a kind and caring manner, practicing the highest standards of quality and safety, or being relentlessly curious as we work towards eradicating childhood diseases, these values are the fabric of our culture and community. The future starts here.</p><p></p><p><b>
Our Commitment
</b></p><p>Seattle Children&rsquo;s welcomes people of all experiences, backgrounds, and thoughts as this is what drives our spirit of inquiry and allows us to better connect with our patients and families. Our organization recruits, employs, trains, compensates, and promotes based on merit without regard to race, religion, color, national origin, gender (including pregnancy, childbirth, or related medical conditions), sexual orientation, gender identity, gender expression, age, status as a protected veteran, status as an individual with a disability, or other applicable legally protected characteristics.</p><p></p><p>
The people who work at Seattle Children&rsquo;s are members of a community that seeks to respect and celebrate all the qualities that make each of us unique. Each of us is empowered to be ourselves.</p><p></p><p>
Seattle Children&rsquo;s is proud to be an Equal Opportunity Workplace and Affirmative Action Employer.</p></div></div></div></div>

Revenue Cycle Analyst - PB, Payer Operations

Norton Healthcare

<div>Responsibilities:
<div>
The Revenue Cycle Analyst acts as the subject matter expert in payor reimbursements and medical policies, while supporting the revenue cycle functions of the organization. This includes, but is not limited to, preparing and forwarding patient claims to appropriate third-party payors, analyzing and reviewing claims to ensure compliance with payor specific requirements, following up on outstanding claims and performing billing and collections activities that directly influence meeting metric goals (e.g. cash, denial rates and days in AR). The Revenue Cycle Analyst also identifies patterns and trends with payors, as well as internal processes, to recommend and implement process improvements, while ensuring leadership&rsquo;s awareness and alignment.</div><div></div><div><br>
**<b>This position offers a fully remote work opportunity. Employees in this role must reside in one of the following states to be considered for fully remote positions: Kentucky, Indiana, Missouri, Ohio, Tennessee, Alabama, Virginia, Mississippi, North Carolina, South Carolina**</b></div>
Qualifications:
<div><b>
Required:</b></div><ul><li><div>
With Associate's degree, one year of Revenue Cycle experience</div></li><li><div>
Without Associate's degree, three years of Revenue Cycle experience</div></li></ul><div><b>
Desired:</b></div><ul><li><div>
Associate's Degree</div></li></ul></div>

Revenue Cycle Analyst, Billing, Days, Fully Remote

Knowtion Health

<div><p>Are you seeking an exciting opportunity to join a passionate, growing, and dynamic team of professionals who support patients?</p>
<p>The IDR Analyst serves as a subject matter expert responsible for managing a specific client&rsquo;s Out of Network inventory, leveraging strong project management and revenue cycle skills to identify trends and patterns that support the strategic submission of IDR disputes aimed at maximizing reimbursement for Knowtion Health.</p>
<p><b>What&rsquo;s Attractive to the Right Candidate?</b></p>
<ul><li>Knowtion Health is a growing firm in a growing industry. Our status as a leader in this industry means that we have the resources to invest in the business and to innovate.</li>
<li>Our business is intensely competitive and is constantly evolving. We quickly identify new challenges and develop solutions, so you won&rsquo;t simply be doing what was done last year. Our new employees are frequently pleased and surprised by how quickly we make decisions and adapt to market conditions.</li>
<li>Knowtion Health culture is inviting and competitive, embracing challenge and celebrating accomplishment; dedicated colleagues striving to provide quality results that have lasting impact.</li>
</ul>
<p><b>The Opportunity:</b></p>
<ul><li>Submit Open Negotiation letters and IDR Disputes for federal and state processes</li>
<li>Analyze insurance cards and EOBs to determine if a claim is Self Funded or Fully Funded</li>
<li>Run reports to identify trends and patterns within claims inventory to drive workflow including any bulk account actions that can be applied to the inventory (Example: non-viable IDR submissions)</li>
<li>Manage relationships with Out of Network payers to establish a claim settlement process where applicable</li>
<li>Analyze data to identify areas for improvement within inventory for billing, claim reimbursement, and follow-up processes</li>
<li>Validate analytics using data from client systems</li>
<li>Review insurance companies&rsquo; payment patterns and denials to identify any trends and irregularities.</li>
<li>Reconcile inventory including payments, adjustments and returned accounts as needed</li>
<li>Present IDR findings in a clear and concise manner to clients and internal stakeholders</li>
<li>Work closely with product management and implementation teams regarding any new operational analytic enhancements which may be needed for one or many clients.</li>
</ul>
<p><b>What you bring:</b></p>
<ul><li>Bachelor's Degree or equivalent experience
</li><li>3+ years of experience in hospital revenue cycle analytics preferred or equivalent experience in hospital accounts receivable claims management</li>
<li>Experience in reviewing insurance cards, EOBs, and claims data
</li><li>Knowledge of Revenue Cycle and different Revenue Cycle systems/applications</li>
</ul>
<p>The above statements are intended to provide the general nature and level of work being performed by most people assigned to the position. They are not intended to be an exhaustive list of all responsibilities, duties and requirements.</p>
<p>This position is remote and requires a dedicated, distraction-free work space at home. We offer a competitive benefits package including medical, dental, vision, life insurance, short term disability, long term disability, paid holidays, 401k, and a generous PTO policy.</p>
<p>Knowtion Health gives priority to applicants located in the following states: AL, AR, AZ, FL, GA, ID, IN, KS, ME, MI, MO, MS, NC, NM, OK, PA, SC, TN, TX, VA, WI, WV</p>
<p><b>Photo Identification and Image Capture Notice</b></p>
<p>As part of our hiring process, candidates are required to present a valid government-issued photo ID during screening and/or interviews.</p>
<p>We may also capture a photograph during the screening or interview process for identity verification, security, and record-keeping purposes. All identification documents and images will be handled in accordance with applicable privacy laws and accessed only by authorized personnel.</p>
<p>By proceeding with your application, you acknowledge and consent to this process.</p></div>

Revenue Cycle IDR Analyst

Huron Consulting Group

<div><p>Huron helps its clients drive growth, enhance performance and sustain leadership in the markets they serve. We help healthcare organizations build innovation capabilities and accelerate key growth initiatives, enabling organizations to own the future, instead of being disrupted by it. Together, we empower clients to create sustainable growth, optimize internal processes and deliver better consumer outcomes.<br>
<br>
Health systems, hospitals and medical clinics are under immense pressure to improve clinical outcomes and reduce the cost of providing patient care. Investing in new partnerships, clinical services and technology is not enough to create meaningful and substantive change. To succeed long-term, healthcare organizations must empower leaders, clinicians, employees, affiliates and communities to build cultures that foster innovation to achieve the best outcomes for patients.<br>
<br>
Joining the Huron team means you&rsquo;ll help our clients evolve and adapt to the rapidly changing healthcare environment and optimize existing business operations, improve clinical outcomes, create a more consumer-centric healthcare experience, and drive physician, patient and employee engagement across the enterprise.<br>
<br>
Join our team as the expert you are now and create your future.</p><p></p>
As the Revenue Cycle Incident Analyst, you will the client support a large Electronic Health Records (EHR) implementation initiative. In this role, you will be a key problem-solver and investigator for all business and financial operations within the Oracle Health (Cerner) Millennium EHR. You will be responsible for the day-to-day analysis of system incidents related to the revenue cycle, performing data-driven root cause analysis to identify trends and underlying issues.<p></p><p>
As the Revenue Cycle Incident Analyst, you will:</p><ul><li><p>
Collaborate closely with technical teams to explain the business impact of issues and with functional end-users to communicate resolutions and workflow changes</p></li><li><p>
Leverage your problem solving ability to analyze complex data and translate technical findings in to actionable business insights</p></li><li><p>
Triage and investigate all incidents related to the revenue cycle solutions, including Patient Accounting, Charge Services, Registration, and Scheduling</p></li><li><p>
Perform data-driven root cause analysis to identify trends, systemic issues, and the underlying cause of recurring problems</p></li><li><p>
Develop clear, concise recommendations for resolution to be provided to technical and application build teams</p></li><li><p>
Collaborate with technical teams to ensure a clear understanding of the business requirements for a proposed fix</p></li><li><p>
Develop and execute functional test scenarios to validate that system fixes have resolved the reported issue without causing unintended downstream consequences</p></li><li><p>
Track the progress of incidents from initial report through final resolution and closeout, ensuring timely burndown</p></li><li><p>
Create reports and dashboards to summarize incident trends, root causes, and resolution times for leadership</p></li></ul><p></p><p>
Requirements:</p><ul><li><p>
A minimum of 3-5 years of experience in a relevant role such as application support analyst, revenue cycle analyst, or business intelligence analyst within a healthcare setting.</p></li><li><p>
Oracle Health/Cerner Expertise: Direct, hands-on experience with the Oracle Health (Cerner) Millennium platform, with a focus on revenue cycle solutions like Patient Accounting, Charge Services, Registration, or Scheduling. Domain Expertise: Demonstrated expertise in revenue cycle workflows (claims, billing, denials, charge capture).</p></li><li><p>
Must possess strong analytical, troubleshooting, and problem-solving skills.</p></li><li><p>
Communication: Excellent verbal and written communication skills, with the ability to clearly document technical issues and explain resolutions to a non-technical audience.</p></li><li><p>
Bachelor&rsquo;s degree, Master&rsquo;s preferred for senior or technical leadership roles</p></li><li><p>
Ability to analyze complex issues and support decision making</p></li><li><p>
Strong communication and collaboration skills with the ability to work effectively in dynamic, cross-functional environments</p></li><li><p>
Experience with documentation and structured reporting as well as familiarity with productivity and tracking tools</p></li><li><p>
Experience working within the DoD, Veteran&rsquo;s Health Administration (VHA) or Military Hospital System (MHS) a plus</p></li><li><p>
Must be a United States Citizen</p></li><li><p>
Candidates must comply with applicable client requirements, such as immunization and occupational health mandates</p></li><li><p>
Willingness to travel to client sites 25% of the time and perform remote work as needed</p></li></ul><p></p><h2 class="jobSectionHeader"><b>
Position Level</b></h2>
Consultant<p></p><h2 class="jobSectionHeader"><b>
Country</b></h2>
United States of America</div>

Oracle Health Revenue Cycle Incident Analyst

South Central Regional Medical Center

<div><p><b>Epic Billing Claims &amp; Electronic Remittance Analyst &ndash; Job Description</b></p><p><b>
Position Summary</b></p><p>
The Epic Billing Claims and Electronic Remittance Analyst is responsible for the design, build, optimization, and support of Epic Revenue Cycle functionality related to claims submission, remittance advice (ERA), and payer connectivity. This role partners closely with Revenue Cycle, Patient Financial Services, IT, and external payers to ensure accurate, timely billing and reimbursement while supporting continuous optimization and regulatory compliance.</p><p><b>
Application Build &amp; Configuration</b></p><ul><li>
Configure, support, and optimize Epic Billing Claims, Electronic Remittance (ERA), and related Revenue Cycle workflows.</li><li>
Build and maintain claim formats, payer edits, remittance routing, adjustment reason codes and posting logic.</li><li>
Support clearinghouse integrations and payer connectivity.</li><li>
Configure and troubleshoot ANSI X12 transactions (837, 835, 276/277, 999).</li><li>
Maintain payers-specific rules, claim edits, and remittance mapping.</li></ul><p><b>
Claims &amp; Remittance Operations</b></p><ul><li>
Troubleshoot claim rejections, denials and remittance posting issues.</li><li>
Analyze payer responses and identify root causes of claim failures or posting discrepancies.</li><li>
Support electronic payment posting, secondary billing and reconciliation processes.</li><li>
Partner with billing and follow-up teams to improve first-pass claim acceptance and payment accuracy.</li></ul><p><b>
Optimization &amp; Reporting</b></p><ul><li>
Participate in optimization initiatives to improve claims throughput, reimbursement accuracy and cash flow.</li><li>
Analyze workflows and recommend system enhancements aligned with Epic best practices.</li><li>
Develop and maintain reports and dashboards related to claims status, remittance posting and payer performance.</li><li>
Support system upgrades, patches and new Epic functionality related to billing and remittance.</li></ul><p><b>
Collaboration &amp; Governance</b></p><ul><li>
Collaborate with operational stakeholders, payers, clearinghouses, and vendor partners.</li><li>
Participate in governance groups, optimization committees, and project workgroups.</li><li>
Assist with testing (unit, integrated, and user acceptance testing) for Revenue Cycle changes.</li><li>
Provide end-user training, documentation, and ongoing support.</li></ul><p><b>
Compliance &amp; Quality</b></p><ul><li>
Ensure Epic build and workflows comply with regulatory requirements (CMS, HIPAA, payer rules).</li><li>
Support audits related to billing, claims, and remittance processing.</li><li>
Follow change management and documentation standards.</li></ul><p><b>
Qualifications</b></p><p><b>
Required</b></p><div><ul><li>
Bachelor&rsquo;s degree in Information Systems, Business, Healthcare Administration, or a related field; <b>or equivalent experience</b>.</li><li>
1&ndash;3+ years of Epic experience preferred (Hospital Billing, Professional Billings, Claims, and Remittance).</li><li>
Hands-on experience supporting revenue cycle with focus on claims and electronic remittance.</li><li>
Understanding of healthcare billing workflows and payer interactions.</li><li>
Knowledge of EDI transactions (837, 835) and remittance processes.</li></ul></div><ul><li>
Strong analytical, problem‑solving, and troubleshooting skills.</li><li>
Excellent communication and customer service abilities.</li></ul><p><b>
Preferred</b></p><ul><li><b>
Epic certification in Billing</b> or willingness to obtain within 90 days.</li></ul><p><b>
Competencies</b></p><ul><li>
Ability to translate billing workflows into technical Epic configuration.</li><li>
Strong attention to detail and commitment to documentation accuracy.</li><li>
Ability to work both independently and collaboratively with clinical teams.</li><li>
Strong organization, time management, and prioritization skills in a fast‑paced environment.</li><li>
Discretion and ability to manage PHI and sensitive patient information.</li><li>
Experience with Epic Hyperspace, Reporting Workbench, SmartTools, or clinical decision support is a plus.</li></ul><p><b>
Work Environment</b></p><ul><li>
Standard office environment with hybrid or in‑office options based on organizational policy.</li><li>
Occasional after‑hours or on‑call support during upgrades, go‑lives, and critical clinical workflows.</li></ul></div>

BILLING CLAIMS & ELECTRONIC REMITTANCE ANALYST

CenterWell

<div><h1 class="jobSectionHeader"><b>Become a part of our caring community</b></h1><p></p><p><br>
As a <b>Revenue Cycle EDI Systems Analyst</b>, you will report to the VP, RCM. You will be responsible for supporting, monitoring, and optimizing revenue cycle systems utilized by the FSU. You will ensure accurate and timely billing, compliance with regulatory requirements, and efficient workflows for receivable management activities. The Revenue Cycle Systems Analyst acts as a liaison between the FSU and other internal teams, as well as external business partners, to streamline revenue cycle performance and enhance system functionality.</p><p></p><p><b>
Key Responsibilities</b></p><p></p><p><b>
System Management &amp; Optimization:</b></p><ul><li><p>
Support and configure revenue cycle applications utilized for billing and claims management.</p></li><li><p>
Identify and implement process improvements to reduce denials and accelerate reimbursements.</p></li><li><p>
Collaborate with FSU, IT and vendors to troubleshoot and resolve system issues and coordinate upgrades or integrations.</p></li></ul><p></p><p><b>
Data Analysis &amp; Reporting:</b></p><ul><li><p>
Monitor revenue cycle metrics such as errors, rejections and denial rates.</p></li><li><p>
Utilize dashboards and reports to track and identify billing and collections trends.</p></li><li><p>
Provide actionable insights to leadership for decision-making.</p></li></ul><p></p><p><b>
Compliance &amp; Quality Assurance:</b></p><ul><li><p>
Ensure systems align with CMS, HIPAA, and payer requirements.</p></li><li><p>
Respond to internal and external audit and data requests.</p></li><li><p>
Support staff with system use and system issues.</p></li></ul><p></p><p><b>
EDI Transaction Management:</b></p><ul><li><p>
Manage, analyze, and optimize electronic data transactions (837, 835, 270/271, etc.) between the FSU and external vendors.</p></li><li><p>
Collaborate with clearinghouses and payers to resolve transmission, billing and adjudication errors.</p></li><li><p>
Ensure timely submission of claims and receipt of remittance advice.</p></li></ul><p></p><p><b>
Cross-Functional Collaboration:</b></p><ul><li><p>
Partner with internal and external teams to ensure system functionality supports departmental and company goals.</p></li><li><p>
Work with finance to reconcile payments and resolve discrepancies.</p></li><li><p>
Support and train staff on System functionality, EDI processes and best practices.</p></li></ul><p></p><p><b>
Process Improvement:</b></p><ul><li><p>
Evaluate current workflows and recommend enhancements to improve efficiency, reduce costs, and ensure accurate and timely billing.</p></li><li><p>
Collaborate with cross-functional teams to implement new procedures and track effectiveness.</p></li></ul><h1 class="jobSectionHeader"><b><br>
Use your skills to make an impact</b><br>
<b>
</b></h1><p><b>Requirements</b></p><ul><li><p>
3 or more years of experience in healthcare revenue cycle and EDI, preferably in home health or post-acute care.</p></li><li><p>
Strong knowledge of HIPAA transactions (837, 835, 270/271, etc.), EMR/EHR systems, and clearinghouse platforms.</p></li><li><p>
Analytical skills with proficiency in Microsoft Office applications.</p></li><li><p>
Understanding of healthcare regulations, reimbursement models, and compliance standards.</p></li><li><p>
Excellent problem-solving, communication, and organizational abilities.</p></li></ul><p></p><p><b>
Preferred Requirements</b></p><ul><li><p>
Bachelor's degree in Health Information Management, Computer Science, Business Administration, Healthcare Management, Data Analytics or related field, or equivalent experience.</p></li><li><p>
Experience with revenue cycle automation tools and workflow optimization.</p></li><li><p>
Familiarity with Medicare/Medicaid billing processes specific to home health.</p></li><li><p>
Proficiency in file transfer software.</p></li><li><p>
Project management or process improvement experience.</p></li></ul><p></p><p><b>
Additional Information:
</b></p><p></p><p>To ensure Home or Hybrid Home/Office employees' ability to work effectively, the self-provided internet service of Home or Hybrid Home/Office employees must meet the following criteria:</p><ul><li><p>
At minimum, a download speed of 25 Mbps and an upload speed of 10 Mbps is required; wireless, wired cable or DSL connection is suggested.</p></li><li><p>
Satellite, cellular and microwave connection can be used only if approved by leadership.</p></li><li><p>
Employees who live and work from Home in the state of California, Illinois, Montana, or South Dakota will be provided a bi-weekly payment for their internet expense.</p></li><li><p>
Home or Hybrid Home/Office employees will be provided with telephone equipment appropriate to meet the business requirements for their position/job.</p></li><li><p>
Work from a dedicated space lacking ongoing interruptions to protect member PHI / HIPAA information.</p></li></ul><p></p>
Travel: While this is a remote position, occasional travel to Humana's offices for training or meetings may be required.<p></p><p><b>
Scheduled Weekly Hours</b></p><p></p>
40<p></p><p><b>
Pay Range</b></p>
The compensation range below reflects a good faith estimate of starting base pay for full time (40 hours per week) employment at the time of posting. The pay range may be higher or lower based on geographic location and individual pay will vary based on demonstrated job related skills, knowledge, experience, education, certifications, etc.<br>
<p></p>
$60,800 - $82,900 per year<p></p><p><b><br>
Description of Benefits</b></p>
Humana, Inc. and its affiliated subsidiaries (collectively, &ldquo;Humana&rdquo;) offers competitive benefits that support whole-person well-being. Associate benefits are designed to encourage personal wellness and smart healthcare decisions for you and your family while also knowing your life extends outside of work. Among our benefits, Humana provides medical, dental and vision benefits, 401(k) retirement savings plan, time off (including paid time off, company and personal holidays, volunteer time off, paid parental and caregiver leave), short-term and long-term disability, life insurance and many other opportunities.<p></p>
Application Deadline: 04-21-2026<h1 class="jobSectionHeader"><br>
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About us</b><br>
</h1>
About CenterWell Home Health: CenterWell Home Health specializes in personalized, comprehensive home care for patients managing a chronic condition or recovering from injury, illness, surgery or hospitalization. Our care teams include nurses, physical therapists, occupational therapists, speech-language pathologists, home health aides, and medical social workers &ndash; all working together to help patients rehabilitate, recover and regain their independence so they can live healthier and happier lives.<p></p>
About CenterWell, a Humana company: CenterWell is a leading healthcare services business focused on creating integrated and differentiated experiences that put our patients at the center of everything we do. The result is high-quality healthcare that is accessible, comprehensive and, most of all, personalized. As the largest provider of senior-focused primary care, a leading provider of home healthcare and a leading integrated home delivery, specialty, hospice and retail pharmacy, CenterWell is focused on whole health and addressing the physical, emotional and social wellness of our patients. CenterWell is part of Humana Inc. (NYSE: HUM). Learn more about what we offer at CenterWell.com.<p><br>
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<b>Equal Opportunity Employer</b></p><p></p><p>
It is the policy of Humana not to discriminate against any employee or applicant for employment because of race, color, religion, sex, sexual orientation, gender identity, national origin, age, marital status, genetic information, disability or protected veteran status. It is also the policy of Humana to take affirmative action, in compliance with Section 503 of the Rehabilitation Act and VEVRAA, to employ and to advance in employment individuals with disability or protected veteran status, and to base all employment decisions only on valid job requirements. This policy shall apply to all employment actions, including but not limited to recruitment, hiring, upgrading, promotion, transfer, demotion, layoff, recall, termination, rates of pay or other forms of compensation and selection for training, including apprenticeship, at all levels of employment.</p></div>

Home Healthcare Revenue Cycle EDI Systems Analyst

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