Revenue Analyst
Job Description
The Revenue Analyst plays a critical role in supporting the financial health of Kinston Community Health Center by analyzing revenue cycle data, identifying trends and opportunities, and providing actionable insights to optimize reimbursement. This position focuses on FQHC-specific revenue streams - including Medicaid, Medicare, prospective payment system (PPS) encounter rates, sliding fee scales, 340B, and grant-funded services.
Qualifications
Education:
- Associates degree in Finance, Accounting, Healthcare Administration, Business Analytics, or related field, bachelor’s degree preferred
Certifications & Licenses:
- None
Experience:
- 1–2 years of experience in healthcare revenue cycle analysis, preferably in an FQHC, community health center, or ambulatory care setting.
Knowledge, Skills, Abilities:
- Strong proficiency in Microsoft Excel (pivot tables, formulas, charts), data visualization tools (Power BI preferred), and EHR/billing systems.
- Knowledge of FQHC reimbursement methodologies, 340B, Medicaid/Medicare rules, and healthcare coding/billing processes is highly preferred.
- Excellent analytical, problem-solving, and communication skills with attention to detail.
- Ability to work independently in a fast-paced, mission-driven environment.
- Ability to establish and maintain effective working relationships
- Ability to communicate effectively both verbally and in writing
- Ability to maintain confidentiality and comply with HIPAA requirements.
Essential Duties and Responsibilities
Revenue Analysis & Reporting
- Analyze revenue cycle performance using data from the EHR/billing system (e.g., NextGen), producing regular reports on key metrics such as days in A/R, clean claim rate, denial rates, collection ratios, and net revenue.
- Monitor and forecast net patient revenue, contractual adjustments, bad debt, and payer trends specific to FQHC reimbursement models (wrap claims, encounter rates, etc.).
- Develop and maintain dashboards (Excel, Power BI, or similar) to visualize revenue performance, variances, and opportunities for improvement.
- Conduct root cause analysis on denials, underpayments, and revenue leakage; recommend process improvements.
Data Management & Optimization
- Perform detailed reviews of charge capture, coding accuracy, claims data, and payment posting to ensure complete and accurate revenue recognition.
- Support month-end revenue reconciliation, accruals, and financial statement preparation.
- Identify opportunities to enhance revenue through improved documentation, charge capture, payer contract management, and value-based care initiatives.
- Assist with UDS reporting, cost reports, HRSA compliance, and other regulatory filings related to revenue.
Collaboration & Process Improvement
- Partners with Billing, Health Informatics and Information Management (HIIM), and Patient Access teams to address issues impacting revenue (e.g., no-show reduction, provider productivity, documentation gaps).
- Participate in PDSA quality improvement projects focused on revenue cycle efficiency.
- Support audits (internal/external) by preparing documentation and responding to inquiries.
- Stay current on changes in FQHC regulations, payer policies (Medicare, Medicaid, commercial), and coding guidelines (ICD-10, CPT, HCPCS).
Additional Duties
- Handle ad-hoc financial analyses and special projects as requested by the Director of Revenue Cycle or CFO.
- Provide training and support to revenue cycle staff on data tools, reporting, and best practices.
- Assist with payer contract negotiations and credentialing data analysis when needed.
- All other duties as assigned.
Work Environment & Schedule
- Must be able and comfortable working in a variety of settings including, but not limited to clinical environments and office spaces.
- Must be able to work nights and weekends as departmental needs arise.
Travel Requirements
- NA
Core Competencies
- Communication: Demonstrates strong verbal, written, and digital communication skills; able to clearly explain complex information.
- Judgment & Decision-Making: Provides thoughtful input into operational and program decisions.
- Accountability & Self-Management: Works independently and efficiently, managing multiple responsibilities with minimal supervision.
- Teamwork & Collaboration: Builds effective working relationships across teams, departments, and the community.
- Problem-Solving & Initiative: Applies critical thinking and initiative to resolve issues and improve service delivery.
Service Delivery Expectations
- Demonstrates compassion and respect in all interactions, treating patients, community members, and colleagues with dignity and cultural sensitivity.
- Supports the organization’s mission to improve the health of our communities by helping ensure services, information, and resources are accessible to those we serve.
- Communicates clearly and effectively with diverse populations while actively listening and responding to community needs.
- Maintains confidentiality and handles sensitive information with professionalism and integrity.
- Upholds organizational standards, policies, and procedures while promoting high-quality service and continuous improvement.
- Demonstrates accountability and stewardship by managing time effectively, prioritizing responsibilities, and meeting deadlines.
- Shows awareness of the community served and supports initiatives that improve access to care and health education.
- Projects a professional image and collaborates with colleagues, providing guidance or leadership when coordinating activities or supporting team efforts.
- Maintains compliance with HIPAA and patient confidentiality requirements.
- Follows workplace safety standards and infection control policies when present in clinical environments.
Physical Demands
- Prolonged periods of sitting while working at a computer and viewing screens.
- Frequent use of hands and fingers for typing, writing, and operating office equipment.
- Requires close visual acuity to read screens, prepare and review documents, and assess information.
- Occasional standing and walking.
- Ability to move throughout office and clinical spaces as needed to perform job duties.
- Occasional lifting, carrying, or moving materials, equipment, or supplies weighing up to 25–50 pounds.
- Ability to communicate clearly and effectively, both verbally and in writing.
Reasonable accommodations may be made to enable individuals with disabilities to perform the essential functions of this position.
Supervisory & Leadership Responsibilities
- NA
Compliance Responsibilities
As part of Kinston Community Health Center’s commitment to ethical practices and regulatory compliance, all employees are expected to:
- Act in accordance with the KCHC Employee Handbook, policies and procedures, and all applicable federal and state laws.
- Promptly report any known or suspected violations of compliance/safety standards.
These responsibilities are essential to maintaining a culture of integrity and accountability across the organization.
Background Requirements
• Must successfully pass required background checks in accordance with organizational policy.
• Must comply with all organizational credentialing and screening requirements.