RCM Analyst

Role Overview:

The RCM Analyst supports the Revenue Cycle Management department through reporting data analysis and business intelligence activities with primary responsibility for analytical support of the RCM Intelligence and Payor Relations functions. The RCM Analyst is expected to deliver accurate timely and actionable reporting and analysis that improves visibility into payor credentialing and revenue cycle performance.

The Analyst will identify meaningful trends and potential issues support leadership decision-making with reliable data maintain strong data integrity and contribute to improvements in reporting efficiency and operational processes. This role requires solid technical skills in data analysis database querying and business intelligence tools. Healthcare and insurance knowledge is not a prerequisite the RCM Intelligence Manager will provide domain training but strong technical capability is required from day one

Essential Duties & Responsibilities:

Reporting & Analytics

• Develop maintain and enhance recurring reports dashboards scorecards and ad hoc analyses supporting RCM operations.
• Collect validate organize and analyze data from practice management systems billing platforms payor portals credentialing systems contract databases and other data sources.
• Identify trends variances anomalies and opportunities for improvement within operational and financial data.
• Support the development and monitoring of key performance indicators and provide timely reporting to leadership and business stakeholders.
• Perform data validation and reconciliation to ensure reporting accuracy consistency and integrity.
• Assist with automating recurring reports and improving reporting processes to reduce manual effort.
• Translate analytical findings into clear summaries visualizations and actionable insights for non-technical stakeholders.
• Participate in projects involving data integration reporting improvements system enhancements and operational optimization.

Payor Relations Support

• Analyze payor performance reimbursement trends negotiated rates underpayments denials and reimbursement variances.
• Develop and maintain reporting processes to monitor negotiated reimbursement rates and payor compliance.
• Support benchmarking of reimbursement across commercial insurance Medicare Advantage Medicaid and other payor arrangements.
• Assist with financial analysis related to payor contract negotiations renewals rate changes and proposed contract terms.
• Maintain and update contract and reimbursement information within internal databases and reporting tools.
• Develop analyses and models to quantify the potential financial impact of reimbursement changes and other payor-related initiatives.
• Assist with identifying and escalating trends that may negatively impact reimbursement collections or overall revenue cycle performance.
• Support analysis of insurance contracts and reimbursement structures for existing and prospective practices.
• Credentialing Analytics Support
• Develop and maintain reporting related to provider credentialing enrollment participation and related operational activities.
• Track and report on credentialing status enrollment progress aging expirations turnaround times and outstanding requirements.
• Identify trends bottlenecks and opportunities to improve credentialing workflows and operational visibility.
• Support data reconciliation and validation between credentialing records provider information payor data and other relevant systems.
• Maintain accurate and well-documented datasets related to providers locations payors participation status and credentialing activities.

Qualifications

Education & Experience

• Bachelors degree in Data Analytics Business Analytics Computer Science Statistics Information Systems or a related technical field preferred.
• 2 to 4 years of experience in data analysis business intelligence reporting or related field.
• Demonstrated experience building reports and dashboards in Power BI or a comparable business intelligence platform required.
• Experience writing SQL queries to extract transform and analyze data from relational databases required.
• Experience working with financial operational or insurance-related data is an advantage but not required.

Knowledge Skills & Abilities

• Proficiency in Power BI including report building data visualization and working with data models. Experience with DAX measures is a strong plus.
• Working SQL skills with the ability to write queries independently including joins filters aggregations and subqueries.
• Advanced proficiency in Microsoft Excel including formulas pivot tables lookups and structured data analysis.
• Experience working with relational databases and understanding how data tables relationships and keys work.
• Familiarity with ETL concepts data pipelines or data integration between systems is preferred.
• Familiarity with healthcare data practice management systems billing platforms or insurance data is helpful but can be developed on the job.
• Strong analytical and problem-solving skills with the ability to identify trends variances and meaningful patterns in data.
• Strong attention to detail and ability to work accurately with large and complex datasets.
• Ability to manage multiple priorities and complete assignments within established deadlines.
• Strong written verbal and presentation skills with the ability to communicate analytical findings to both technical and non-technical stakeholders.
• Ability to work independently and collaboratively in a cross-functional environment.
• Commitment to data integrity documentation confidentiality and continuous improvement.

Working Conditions:

• Must be able to sit/stand for extended periods of time.
• Must be able to reach overhead as needed.
• Must be able to lift and carry up to 25 pounds as needed.
• Must be able to work in a fast-paced environment.
• Must be able to maintain attention to detail for extended periods.
• Must be able to operate standard office equipment.
• Must be able to work flexible hours including evenings or weekends if required.
• Must be able to perform duties with or without reasonable accommodation.

Benefits:

• BCBS High Deductible & PPO Medical Insurance Options
• VSP Vision Coverage
• BCBS PPO Dental Insurance
• Complimentary Life Insurance Policy
• Short-term & Long-Term Disability
• Pet Insurance Coverage
• 401(k) plan
• HSA / FSA Account Access
• Identity Theft Protection
• Legal Services Package
• Hospital/Accident/Critical Care Coverage
• Paid Time Off
• Diverse and Inclusive Work Environment
• Base salary and bonus structure

About Us:

Specialty1 Partners is a practice services organization committed to providing non-clinical business support services to the nations leading specialty dental practices. The company was founded in 2019 by four endodontists who wanted to provide unique and differentiated support to specialty dental practices. Originally focusing on support to endodontics practices (under the Endo1 brand) Specialty1 Partners quickly expanded its support to periodontics and oral surgery practices.

Since its founding Specialty1 Partners has grown rapidly to become one of the largest private owners of specialty dental practices in the US. Headquartered in Houston TX Specialty1 Partners is led by its founders and a management team that is focused on ongoing growth and delivery of best-in-class services across its network of practices. Specialty1 Partners currently has over 230 locations across 28 states.

1800 West Loop S. Suite 2000 Houston TX 77027

Specialty1 Partners and its affiliates are equal-opportunity employers who recognize the value of a diverse workforce. All suitably qualified applicants will receive consideration for employment based on objective criteria and without regard to the following (which is a non-exhaustive list): race color age religion gender national origin disability sexual orientation gender identity protected veteran status or other characteristics in accordance with the relevant governing laws. Specialty1 Partners Privacy Policy and CCPA statement are available for view and download at Partners and all its affiliates participate in the federal governments E-Verify program. Specialty1 further participates in the E-Verify Program on behalf of the clinical practice entities which are supported by Specialty1. E-Verify is used to confirm the employment authorization of all newly hired employees through an electronic database maintained by the Social Security Administration and Department of Homeland Security. The E-Verify process is completed in conjunction with a new hires completion of Form I-9 Employment Eligibility Verification upon commencement of employment. E-Verify is not used as a tool to pre-screen candidates. For up-to-date information on E-Verify go to click on the Employees Link to learn more.

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