Senior Financial Operations Analyst

Role Overview

• Analyze end-to-end revenue cycle performance to identify trends, risks, and opportunities related to reimbursement, underpayments, denials, and payer compliance.
• Perform variance analysis between expected and actual reimbursement based on contract terms, fee schedules, and payer policies.
• Develop and maintain revenue optimization models focused on yield, net revenue, and denial prevention.
• Track payer performance metrics and identify opportunities for contract optimization and renegotiation support.
• Interpret payer policies, medical necessity criteria, reimbursement methodologies, and payment rules to assess revenue impact.
• Analyze payer contracts and amendments to ensure accurate modeling, payment validation, and compliance with negotiated terms.
• Conduct root-cause analysis on denials and underpayments to identify systemic issues related to coding, authorization, documentation, billing, or payer behavior.
• Support development of denial prevention strategies and monitor effectiveness over time.
• Provide analytical support for appeals prioritization and payer escalation strategies.
• Design and deliver executive-level dashboards and reports highlighting revenue risks, payer trends, and optimization opportunities.
• Translate complex analytical findings into clear, actionable insights for non-technical stakeholders.
• Support revenue cycle initiatives, technology implementations, and performance improvement projects.
• Serve as a subject matter expert in revenue performance analytics, payer reimbursement, and denial analysis.
• Proactively identify opportunities to automate, streamline, and enhance revenue performance reporting and workflows.

Requirements

• Bachelor’s degree in Finance, Healthcare Administration, Business, Analytics, or a related field required
• 5+ years of healthcare revenue cycle experience, with demonstrated focus on payer reimbursement, denials, or managed care analytics
• Proven experience analyzing payer contracts, reimbursement methodologies, and payer policies
• Hands-on experience with denial data, underpayment identification, and revenue integrity initiatives
• Experience working cross-functionally with Revenue Cycle, Managed Care, Finance, and Operations teams
• Strong understanding of healthcare reimbursement (commercial, Medicare, Medicaid)
• Expertise in interpreting payer contracts and translating contract language into analytical models
• Advanced analytical skills with large, complex datasets
• Proficiency in Excel; experience with SQL, Tableau, Power BI, or similar analytics tools preferred

Tech Stack

• SQL
• Tableau

Benefits

• Paid Time Off programs
• Health and welfare benefits such as medical, dental, vision, life, and Short
• and Long-Term Disability
• Flexible Spending Accounts for eligible health care and dependent care expenses
• Family benefits such as adoption assistance and paid parental leave
• Defined contribution retirement plans with employer match and other financial wellness programs
• Educational Assistance Program