RCM Data

Job Title: RCM Data & Performance Analyst (Productivity, Metrics & Process Optimization)Job Summary:

We are seeking a highly analytical and detail-driven RCM Data & Performance Analyst to monitor billing operations, track productivity, identify recurring issues, and provide actionable insights to leadership. The ideal candidate will proactively analyze trends, create meaningful metrics, and highlight critical issues to ensure operational efficiency, financial performance, and strong transparency for clients.

This role plays a key part in ensuring our medical billing processes run smoothly, issues are identified early, and internal stakeholders and clients have accurate visibility into their KPIs.

Key Responsibilities:1. Productivity Tracking & Performance Monitoring

• Track and analyze productivity across billing teams (charges, payments, denials, AR follow-up, EDI operations, etc.).
• Establish benchmarks and performance indicators for individuals and teams.
• Create automated dashboards and daily/weekly productivity reports.
• Monitor SLA adherence, turnaround times, and workload distribution.

2. Claims & Process Issue Analysis

• Identify patterns in claim issues (rejections, denials, delays, trending errors).
• Conduct root-cause analysis for recurring claim-level or system-level problems.
• Flag high-risk issues that may impact cash flow or client satisfaction.
• Recommend corrective actions and collaborate with functional teams to resolve issues.

3. KPI Development & Operational Metrics

• Build and maintain key billing KPIs such as:
• Clean Claim Rate
• First Pass Resolution Rate
• Denial Rate
• Average Days to Bill
• AR Aging insights
• Productivity per employee
• Create clear and actionable metric definitions to standardize performance evaluations across departments.

4. Reporting & Leadership Insights

• Prepare executive-level reports and presentations summarizing operational trends, cash-flow risks, and performance gaps.
• Provide leadership with data-backed recommendations to improve process efficiency and profitability.
• Highlight critical issues using visual indicators, alerts, and data points to support timely decision-making.

5. Process Optimization & Improvement

• Identify process inefficiencies and propose solutions to streamline workflows.
• Recommend automation opportunities using tools like Power BI, Excel, Power Automate, or RPA solutions.
• Partner with cross-functional teams (AR, Coding, EDI, Charge Entry, Credentialing, etc.) to implement improvements.
• Track progress and measure the impact of implemented changes.

6. Client Transparency & Reporting

• Prepare client-facing performance reports and monthly KPI summaries.
• Ensure all data shared with clients is accurate, consistent, and easy to understand.
• Present insights and trends to clients, highlighting opportunities for improvement.
• Maintain transparent communication to build trust and accountability.

Required Skills & Qualifications:

• Minimum 5 years of experience in RCM, medical billing analytics, operations analysis, or business intelligence.
• Strong analytical skills with the ability to interpret complex data sets.
• Proficiency in Excel, pivot tables, VLOOKUP/XLOOKUP, Power Query, or Google Sheets.
• Experience with Power BI, Tableau, or other dashboard tools (preferred).
• Familiarity with medical billing workflows and terminology (charges, payments, denials, EDI, AR, etc.).
• Ability to identify trends, root causes, and performance gaps.
• Strong communication skills to present insights clearly to leadership and clients.
• Ability to work independently, manage deadlines, and handle multiple priorities.
• Experience in process improvement or automations (Power Automate, VBA, RPA tools) is a plus.

Preferred Qualifications:

• Experience working in a Medical Billing / RCM company.
• Understanding of payer trends, denial codes, and EDI transactions.
• Prior exposure to KPI development and data governance.
• Experience building automated workflows or reporting solutions.

Key Outcomes Expected from This Role:

• Strong visibility into operational performance.
• Early detection of issues impacting revenue or client results.
• More efficient and profitable billing operations.
• Clear, transparent reporting to clients and leadership.
• Improved productivity and reduced backlogs.

Job Type: Full-time

Benefits:

• Work from home

Application Question(s):

• Describe the KPIs you have previously tracked in a medical billing or RCM environment. Why were these KPIs important, and how did you use them to drive decisions?
• What tools or methods do you use to analyze large datasets and generate insights
• Have you created productivity or performance dashboards for teams? What metrics did you track, and what improvements came from your reporting?
• Explain the most common denial categories you've encountered. How would you build a reporting structure to track them effectively?
• How do you summarize technical or analytical findings to leadership who may not have analytical or billing backgrounds? Provide an example.
• Why do you believe you're a strong fit for an operations analytics / performance monitoring role in an RCM environment?
• What is your expected compensation for this role?