Job Purpose
The Accounts Receivable Optimization Analyst is the subject matter expert accountable for identifying and resolving the drivers of accounts-receivable underperformance across Medicare, Medicaid, managed care, and commercial payers. The Accounts Receivable Optimization Analyst diagnoses root causes in aging, follow-up productivity, and payment behavior, then works directly with operational leaders and teams to implement operational improvement plans, confirm they are sustained, and prevent recurrence to reduce days in AR, accelerate cash collection, and improve recovery.
Duties & Responsibilities
- Serve as the subject matter expert for AR performance, independently analyzing AR aging, days-in-AR, and cash-collection trends by payer, service location, and financial class to identify the issues with the greatest financial impact
- Determine how AR inventory is segmented and prioritized so follow-up is focused on the highest-value, highest-yield accounts
- Identify gaps in follow-up activity and account coverage, and partner with operational leaders to recommend workflow, resource, or process changes that improve account progression and resolution
- Evaluate payment behavior, underpayments, denials, and contractual variances across Medicare, Medicaid, managed care, and commercial payers to identify trends and determine when payer issues warrant escalation
- Design and reconcile dashboards and performance measures for AR aging, resolution rate, cash acceleration, and recovery used by operational and client leadership
- Lead working sessions with operational leaders and teams to validate root causes, develop corrective action plans, and drive implementation through resolution
- Identify and design workflow logic, worklist, and automation improvements that increase follow-up efficiency
- Monitor implemented corrective actions against baseline performance to confirm issues are resolved and do not recur, re-engaging teams when results fall short
- Advise operational and client leadership on AR risks, recovery opportunities, and recommended priorities
- Other duties as assigned
- Use, protect and disclose patients’ protected health information (PHI) only in accordance with Health Insurance Portability and Accountability Act (HIPAA) standards
- Understand and comply with Information Security and HIPAA policies and procedures at all times
- Limit viewing of PHI to the absolute minimum as necessary to perform assigned duties
Qualifications
- Bachelor’s degree in healthcare administration, business, finance, or a related field; an equivalent combination of education and progressive revenue cycle experience will be considered
- 4+ years of progressive experience in hospital accounts receivable, collections, or revenue cycle analytics, including independently leading AR improvement initiatives
- Advanced knowledge of AR aging, days-in-AR, cash forecasting, and follow-up processes across Medicare, Medicaid, managed care, and commercial payer environments
- Ability to interpret payer remittances, reimbursement methodologies, contractual terms, denial patterns, and variance drivers across multiple payer types
- Demonstrated ability to identify root causes, lead cross-functional teams through corrective action, and sustain results without day-to-day direction
- Experience with Epic Resolute and enterprise AR work-list tools preferred
- Proficiency with BI tools (Power BI, Tableau) and/or SQL preferred
- Prior experience in a large, multi-facility health system preferred
- Proficiency in Microsoft Office Suite, with strong Excel skills (pivot tables, modeling) and data-analysis capability
- Strong interpersonal and influencing skills, with the ability to communicate and present findings at all levels of the organization, including executive leadership
- Strong problem solving and creative skills and the ability to exercise independent judgment and make decisions based on accurate and timely analyses
- High level of integrity and dependability with a strong sense of urgency and results oriented
- Excellent written and verbal communication skills required
Working Conditions
- Occasional travel to client facility sites may be required
- Ability to work outside of business hours to support business needs on occasion
- Must possess a smart-phone or electronic device capable of downloading applications, for multifactor authentication and security purposes
- Physical Demands: While performing the duties of this job, the employee is occasionally required to move around the work area; Sit; perform manual tasks; operate tools and other office equipment such as computer, computer peripherals and telephones; extend arms; kneel; talk and hear
- Mental Demands: The employee must be able to exercise independent judgment, collaborate with others, and handle stress
- Work Environment: The noise level in the work environment is usually minimal
Med-Metrix will not discriminate against any employee or applicant for employment because of race, color, religion, sex (including pregnancy, gender identity, and sexual orientation), parental status, national origin, age, disability, genetic information (including family medical history), political affiliation, military service, veteran status, other non-merit based factors, or any other characteristic protected by federal, state or local law.
