Behavioral Health Claims Analyst Full Time NEW

The Behavioral Health Claims Analyst is responsible for assisting the Director of Billing and RCM in overseeing all aspects of the revenue cycle while leveraging data analytics to improve financial performance, operational efficiency, and revenue integrity. This role manages billing, coding, claims processing, payment posting, accounts receivable, and denial management functions while providing actionable insights through reporting, data analysis, and performance monitoring.

Revenue Cycle Management

• Lead and manage the end-to-end revenue cycle process, including patient registration, charge capture, coding, billing, collections, payment posting, and denial management.
• Monitor key revenue cycle metrics and implement strategies to improve cash flow and reduce accounts receivable days.
• Ensure compliance with payer regulations, contractual requirements, and industry standards.
• Oversee claim submission processes and resolve billing issues, denials, and underpayments.
• Conduct regular audits of billing and coding activities to ensure accuracy and compliance.

Data Analytics & Reporting

• Design, develop, and maintain dashboards, reports, and performance scorecards for revenue cycle operations.
• Analyze financial, operational, and claims data to identify trends, risks, and improvement opportunities.
• Monitor key performance indicators (KPIs) such as clean claim rate, denial rate, collection rate, net collection percentage, and days in accounts receivable.
• Perform root cause analysis on denials, payment variances, and revenue shortfalls.
• Create predictive models and forecasting reports to support strategic decision-making.
• Extract, validate, and analyze data from billing systems, EHRs, and other databases.
• Present analytical findings and recommendations to leadership teams.
• Support process improvement initiatives through data-driven insights.

Leadership & Process Improvement

• Supervise and mentor revenue cycle staff, providing training and performance management.
• Establish departmental goals and monitor progress toward organizational objectives.
• Lead revenue cycle improvement projects and system optimization initiatives.
• Identify automation opportunities to improve operational efficiency and reporting accuracy.

Preferred Qualifications

Education

• Bachelor’s degree in Healthcare Administration, Business Administration, Finance, Accounting, Data Analytics, Information Systems, or a related field.

Experience

• 5+ years of experience in revenue cycle management, healthcare finance, medical billing, or related fields.
• 2+ years of experience in data analytics, business intelligence, or reporting.
• Experience managing teams and cross-functional projects.
• Strong understanding of healthcare reimbursement methodologies, payer regulations, and revenue cycle operations.

Technical Skills

• Advanced proficiency in Microsoft Excel.
• Knowledge of healthcare billing systems, EHR platforms, and practice management software.
• Strong analytical, problem-solving, and reporting skills.

Benefits

• Competitive salary
• Health, dental, and vision insurance
• Paid time off and holidays
• 401(k) with employer match
• Opportunities for professional growth

Job Type: Full-time

Pay: Starting at $53,000/ year

Schedule

• Monday – Friday