Revenue Cycle Operations Analyst

The Revenue Cycle Operations Analyst plays a critical role in safeguarding the financial and operational health of Imagine Pediatrics. This role ensures the integrity, accuracy, and compliance of all billing and coding operations across Imagine’s multi-state payer landscape. This position is responsible for identifying claim-level breakdowns, denial trends, and systemic risks in real time.

You will perform pre- and post-submission audits of claims to catch billing, modifier, place-of-service, taxonomy, or coding errors before they become denials. You will also monitor payer denials and rejections to identify systemic coding, documentation, or setup issues. You will produce monthly and ad hoc reporting on claim acceptance, denial categories, payer acknowledgement, and reprocessing trends.

You will provide targeted education to coders, billers, and clinical teams based on audit findings. You will work with Credentialing, Clinical, and Compliance teams to resolve issues impacting claim integrity (taxonomy mismatches, enrollment gaps, inactive NPIs).