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UPMC · 6 hours ago

Revenue Cycle Clinical Operations Analyst

Pittsburgh, PA

Full-time

Onsite

Mid Level

$32/hr - $56/hr

3+ years exp

UPMC is hiring multiple Revenue Cycle Clinical Operations Analysts to join the Physician Revenue Cycle Enhancement team. This role involves leading integration efforts within clinical specialties to ensure operational workflows align with revenue cycle processes, requiring strong communication and problem-solving skills.

BiotechnologyHealth CareHospitalMedical

Responsibilities

Serve as a bridge between clinical departments and revenue cycle teams (billing, coding, authorization, etc.) to identify workflow misalignments, process gaps, and opportunities for improvement

Collaborate with providers, nurses, coders, and billing teams to understand pain points and inefficiencies affecting both care delivery and financial performance

Assist in the collection, analysis, and synthesis of feedback from providers and operational stakeholders related to clinical documentation, coding accuracy, billing workflows, and compliance

Support the development and implementation of process improvements that enhance both clinical workflow and revenue cycle outcomes

Help educate providers and clinical teams on best practices related to documentation, coding, and compliance in alignment with revenue integrity goals

Work with the Integrator Team Manager to maintain specialty-specific insight and be curious about trends in feedback, revenue leakage, or operational enhancements

Support the launch of new workflows, documentation standards, or system enhancements by acting as an operational translator between clinical and non-clinical teams

Participate in specialty-specific workgroups to promote alignment between clinical practice and operational standards

Ensure accurate communication of updates, changes, and new processes to clinical and revenue cycle stakeholders in a clear, timely manner

May interact with third-party vendors engaged in specialty-specific support (e.g., documentation consultants, audit firms), helping to align their efforts with clinical and operational priorities

Assist in preparing reports or summaries on feedback trends, operational gaps, and process improvement outcomes

Support training sessions and materials related to workflow changes, revenue cycle practices, or documentation standards

Maintain documentation of workflow issues, resolutions, and educational interventions within the integrator knowledge base or issue-tracking systems

Help identify metrics or KPIs that reflect the impact of integration efforts and participate in efforts to monitor and track them

Partner with other integrators on cross-specialty initiatives that support enterprise-wide clinical and financial alignment

Stay up to date on relevant regulatory changes, payer updates, and organizational initiatives that may impact specialty workflows or revenue cycle functions

Qualification

Healthcare operationsRevenue cycle management (RCM)Electronic health records (EHR)Analytical skillsMicrosoft OfficeProblem-solvingLean certificationSix Sigma certificationInterpersonal communicationCollaborationOrganizational skills