Revenue Cycle Management Analyst III

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At North Bay Health, the Revenue Cycle Management Analyst III supports revenue cycle operations to ensure efficient workflows, management and monitoring of revenue, charges, and revenue cycle internal and external customers. The role ensures established goals are met while adhering to federal and state regulations, policies of external payers, coding rules and guidelines. It requires independent decision making using analytical and problem‑solving skills, providing critical analytical and negotiation support for third‑party payer reimbursement contracts.

The Analyst III works independently, manages multiple priorities, and demonstrates strong analytical and customer service skills. This position requires the ability to communicate complex information to front‑line staff, department leaders, and executives while maintaining professionalism and accuracy.

The role serves as a technical resource, point of contact, and key participant in RCM to develop, test, train, implement, and maintain software associated with departmental functions, including conversions and upgrades. It assists with planning, execution, and finalizing projects, utilizing project management tools, processes, and methodologies within budget and deadlines.

• Coordinate with other departments including finance, decision support, business office, etc., to develop and generate reporting templates for monitoring and troubleshooting revenue performance.
• Assist in development and maintenance of revenue cycle reports, dashboards, and key performance indicators (KPI).
• Collaborate with operational leaders to develop provider education strategies to promote complete and accurate clinical documentation and correct negative trends.
• Support revenue cycle staff and teams as needed.
• Work with managed care and reimbursement departments to respond to strategic initiatives to optimize patient revenue capture.
• Review payments for accuracy from contracted payers and manage the appeals process with each assigned payer in both hospital and clinic settings.
• Perform contract and reimbursement variance analysis.
• Perform related administrative duties to ensure the effectiveness and optimum maintenance of the applications.
• Support management of projects and workflow reengineering.
• Run, review, interpret, analyze, and validate Revenue Cycle reports.
• Run Revenue Cycle and operations reports to answer questions from department/practice managers, physicians, and other stakeholders.
• Take an active role in new service research and assessment.
• Assist in quantifying audit outcomes, including revenue realized.
• Play a key role in creating training manuals and job aids for respective areas of expertise.
• Develop, recommend, and implement new programs and projects as directed by the Revenue Cycle leadership team.
• Research, work with large sets of data, review, interpret, and follow all relevant policies, procedures, regulations, guidelines and laws and attend mandatory training.
• Participate in regularly scheduled department meetings, training seminars, or sessions as assigned.
• Plan, organize, and prioritize workload and process information at the necessary speed for job performance.
• Adhere to the department’s rules, guidelines, and procedures for lunch and break times, requesting time‑off and changes in shift