Receivables Management Analyst

SUMMARY:

The Receivables Management Analyst plays a critical role in managing and optimizing hospital billing operations. This position ensures accurate submission of claims, compliance with regulatory requirements, and timely resolution of complex billing issues. The role involves advanced data analysis, process improvement, and collaboration across departments to support financial performance and revenue integrity..
Brown University Health employees are expected to successfully role model the organization's values of Compassion, Accountability, Respect, and Excellence as these values guide our everyday actions with patients, customers and one another.

In addition to our values, all employees are expected to demonstrate the core Success Factors which tell us how we work together and how we get things done. The core Success Factors include:

Instill Trust and Value Differences
Patient and Community Focus and Collaborate

RESPONSIBILITIES:

Hospital Billing & Compliance

• Review and validate UB-04 and CMS-1500 claims for inpatient, outpatient, and ancillary services.
• Ensure accurate application of CPT, ICD-10, HCPCS codes, and DRG assignments.
• Monitor payer-specific requirements and resolve claim edits, rejections, and denials.
  • Develop and document workflows to improve efficiency and compliance.
  • Evaluate new technologies for potential implementation.
• Maintain compliance with HIPAA, CMS, and state regulations.

Revenue Cycle Analysis

• Analyze billing data to identify trends in denials, underpayments, and revenue leakage.
• Prepare reports on KPIs such as DNFB (Discharged Not Final Billed), AR aging, and clean claim rates.
• Provide actionable insights to leadership for improving reimbursement and reducing cycle time.
• Troubleshoot and resolve application issues related to billing and claims

Issue Resolution and Escalation

• Handle escalated payer disputes and negotiate resolutions.
• Collaborate with coding, patient access, and clinical teams to resolve complex billing issues.

Process Improvement & Leadership

• Identify and implement process enhancements to improve billing accuracy and efficiency.
• Mentor and train billing analysts and support staff on hospital billing best practices.
• Participate in system upgrades, testing, and implementation of new billing technologies.

MINIMUM QUALIFICATIONS:

• Education: Bachelor's degree in finance, Accounting, Healthcare Administration, or related field preferred.
• Experience:
  • 5+ years in hospital billing or revenue cycle management.
  • Strong knowledge of UB-04 & 1500, CPT/ICD coding, DRG, and payer reimbursement methodologies.
  • Strong knowledge of hospital and professional billing workflows.
• Skills:
  • Advanced proficiency in hospital billing systems (Epic, SSI) and MS Excel.
  • Strong knowledge of hospital and professional billing workflows.
  • Strong analytical, leadership, and communication skills.
  • Experience with EHR systems (Epic certification preferred).

Core Competencies:

• Expertise in hospital billing compliance and payer regulations.
• Ability to manage complex billing scenarios and lead process improvements.
• Strategic thinking and mentoring capabilities.

WORK ENVIRONMENT AND PHYSICAL REQUIREMENTS:

Work is performed in a typical office environment requiring extended periods of sitting, walking and/or standing.

INDEPENDENT ACTION:

Perform independently within department policies and procedures; refers specific problems to supervisor where clarification of departmental policies and procedures may be required.

SUPERVISORY RESPONSIBILITY:

None.

Pay Range:

EEO Statement:

Brown University Health is committed to providing equal employment opportunities and maintaining a work environment free from all forms of unlawful discrimination and harassment.

Location:

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Driving Required: