SENIOR REVENUE CYCLE ANALYST, REVENUE CYCLE MEDICAL GROUP
SGMC Health
Date: 9 hours ago
City: Valdosta, Georgia
Contract type: Full time
Description
Location: SGMC Patient Financial Services
Department: REVENUE CYCLE MEDICAL GROUP
Schedule: Full Time, 8 HR Day Shift, 8-5
Position Summary
Location: SGMC Patient Financial Services
Department: REVENUE CYCLE MEDICAL GROUP
Schedule: Full Time, 8 HR Day Shift, 8-5
Position Summary
- The Senior Revenue Cycle Analyst provides strategic insights and recommendations based on data review and developing reports and tools within and outside of the Epic environment, as well as overseeing the contract management tools within the Epic environment.
- The Senior Analyst develops, mentors and leads junior analysts or equivalent within the Revenue Cycle department.
- The Senior Analyst supports cross-functional teams and senior leadership by developing reports and data analysis, project management to enhance financial performance, denial prevention, and workflow improvements across the organization.
- The Senior Analyst demonstrates advanced operational knowledge of both hospital and physician practice revenue cycle workflows, including front-end access, charge capture, claims management, and payment reconciliation. The Senior Analyst must be proficient in analyzing payer reimbursement methodologies including those from commercial, Medicare, and Medicaid payers, and in auditing payments to validate adherence to contracted terms and applicable regulations. The Senior Analyst plays a critical role in net reimbursement by conducting detailed payment variance analysis, validating contract configurations within Epic post-update, and ensuring end-to-end billing compliance. This includes collaborating with HB, PB, and Revenue Integrity teams to proactively align billing practices with payer-specific contract terms and partnering with Denials Management to identify trends, root causes, and resolution strategies for contract-related denials. This role oversees the full lifecycle of contract management for both Hospital Billing and Professional Billing, including modeling, interpretation, reconciliation, and ongoing maintenance within the Epic system. The Senior Analyst is responsible for continuous monitoring of regulatory and payer policy updates including CMS transmittals, National and Local Coverage Determinations (NCDs/LCDs), and commercial policy bulletins. The Senior Analyst distills and communicates relevant changes to internal stakeholders to ensure enterprise-wide compliance. The Senior Analyst position is instrumental in identifying revenue leakage, modeling financial impact of contract terms, and partnering with leadership to drive improvements in key performance indicators such as denial rates, AR days, and cash collections. The Senior Analyst utilizes advanced data analysis tools such as Excel, Epic workbench reports, and business intelligence platforms to identify patterns in reimbursement, build executive dashboards, and proactively report payer performance trends.
- The role oversees continuous process improvement initiatives by mapping current-state workflows, identifying automation opportunities, and coordinating system enhancement requests in collaboration with Epic analysts and IT support.
- The Senior Analyst supports audit readiness by analyzing post-payment reviews, preparing responses to payer audits, and contributing to mitigation strategies that reduce organizational risk exposure.
- Acts as lead analyst on payer reimbursement and policy updates, delivering training and guidance to billing teams, clinical departments, and leadership to ensure systemwide compliance and consistency.
- The Senior Analyst may supervise one to two analysts or equivalent. This position reports to the VP of Revenue Cycle and directly supports the Hospital and Professional Billing Directors.
- Undergraduate degree in healthcare, business, or finance required, Master’s degree or equivalent preferred o Must demonstrate strong leadership skills and team building capabilities
- Must have 5-7 years progressive, related experience in healthcare, including leadership roles
- Knowledge of various reimbursement methodologies (FFS, DRG, OPPS, IPF, IRF, etc)
- Prior HB and PB billing and/or insurance claim payment experience required o Contract management skills that include modeling and variance reporting
- Knowledge of medical terminology, ICD-10, UB revenue codes, CPT/HCPCS coding, certified coder preferred
- Proficient using Microsoft Office applications used for communication, documentation, planning, and coordination (Outlook, Word, Excel, PowerPoint, Visio, Teams, etc.)
- Experience working with the Epic EHR desired o Excellent organizational and project management skills
- Well-developed research skills o Ability to work independently and effectively handle multiple, concurrent priorities and workloads
- Interpersonal ability and professional demeanor to regularly interact with insurance companies, physicians, and other hospital personnel to effectively communicate processes and resolve issues
- Excellent knowledge of technology and related environments, including cloud, databases, applications, platforms, services, etc.
- On-site business setting, indoors. Remote workers are required to have a designated appropriate and safe workspace that ensures their productivity while maintaining the security of health system information. Moderate/high stress level. On-site moderate noise level. Occasional overtime required. Ability to sit, stand, or walk for moderate periods. Reading of printed materials. Listening and verbally responding to customers, staff, physicians, and visitors. Moderately heavy lifting (0-25 lbs.), reaching, stooping, pushing, puling, bending, and twisting. Exposure to all adult ages and socio-economic backgrounds
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