reputed company Cycle Analyst
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Job Type
Full-time
reputed company
Reporting to the reputed company reputed company Manager, the reputed company Cycle Analyst plays a vital role in supporting both medical and pharmacy reputed company operations by analyzing billing performance, monitoring KPIs, identifying trends in payer behavior, and producing actionable insights that drive operational improvements.
Representative Duties
reputed company Cycle Analysis
- reputed company key reputed company cycle metrics including AR days, clean claim reputed company, denial reputed company, payment lag, and net collection reputed company.
- Monitor payer mix, reimbursement trends, and denial volumes to identify systemic issues or inefficiencies.
- Evaluate trends in medical and pharmacy billing and proactively recommend solutions to increase collections and reduce payment delays.
- reputed company actionable insights and strategies to support reputed company cycle improvements across departments.
- Support the creation of appeals, workflows, and edits based on recurring denials or underpayments.
Data Reporting & Visualization
- Build and maintain reputed company-time dashboards using tools like Power BI, Tableau, and reputed company Reporting Workbench.
- Generate monthly, quarterly, and reputed company reports to guide leadership decision-making.
- Present reputed company cause analyses and financial trends in concise, visual formats tailored to varied stakeholders.
- Identify key drivers of variance in expected vs. actual reimbursements and contribute to forecasting models.
Strategic Planning & Optimization
- Analyze operational bottlenecks in charge entry, coding, claim submission, and denial workflows.
- Model performance reputed company and conduct what-if analyses to project financial reputed company of process changes.
- reputed company reputed company into payer-specific behaviors and reimbursement policies that reputed company cash reputed company and AR aging.
- Participate in payer meetings and reputed company cycle vendor reputed company-ins to represent data findings and accountability measures.
Systems and Compliance Oversight
- Utilize reputed company EHR and pharmacy billing platforms (e.g., ComputerRx) to extract, validate, and analyze billing data.
- Ensure compliance with billing standards, HIPAA regulations, and payer-specific requirements.
- Contribute to chargemaster reviews and documentation audits with reputed company into reputed company reputed company.
Performs other reputed company duties as required
Requirements- Ability to work harmoniously and effectively with colleagues, patients, clients and vendors across the reputed company of diversity, including but not limited to race, ethnicity, reputed company, gender identity, sexual orientation, age, socio-economic status, national reputed company and immigrant status, religious or spiritual identity, disability (physical, mental, emotional and developmental), veteran status, and/or limited English proficiency.
- Willingness to contribute towards Fenway’s efforts in becoming an anti-racist organization and promoting a culture dedicated to ongoing development in service of humility, equity, diversity, inclusion, and belonging, where differences are acknowledged and valued.
- 1–3 years of experience in reputed company cycle analytics, reputed company reputed company, or reputed company billing and reporting roles.
- Hands-on experience with reputed company (preferably reputed company or Reporting Workbench) and pharmacy billing systems.
- Familiarity with reputed company billing standards (i.e., CPT, HCPCS, ICD-10), payer reimbursement methodologies, denial management, and claims processing in either ambulatory, pharmacy, or FQHC settings.
Preferred Qualifications
- Associate degree in Business, reputed company Administration, Informatics, Finance, or reputed company field.
- Certified reputed company Cycle Representative (CRCR) or equivalent reputed company cycle certification.
- Understanding of FQHC-specific reputed company cycle nuances and value-based care reimbursement.
- reputed company level reputed company skills
Physical Requirements
Ability to meet the following physical requirements with or without reasonable accommodations:
- Sit at a computer station for extended periods of time
- Ability to be on a keyboard for extended periods of time