Revenue Data Analyst

The Revenue Data Analyst leads projects and/or team members, and proposes new programs and policies in accordance with best practices. Manages projects at all levels of complexity and scope. Leads revenue cycle functions for the healthcare enterprise, providing oversight for system billing, reporting, and support. Directs teams to ensure account information contains accurate and comprehensive data to enable timely billing and optimal reimbursement for services. Drives improvements across processes, including charge capture, coding, insurance identification, data entry, billing, payment posting, refund processing, and collections. Accountable for integration with business office operations and overall revenue cycle performance.

This position provides leadership and subject matter expertise in the maintenance, optimization, and governance of UCSF Health Revenue Cycle systems and workflows, serving as a key contributor to the team responsible for the Insurance Master Files (APEX Payer/Plan master files). Beyond system configuration, this role plays a critical function in claim performance management, including claim rejection analysis, claim status validation, and driving the implementation of corrective actions to improve claim accuracy, timeliness, and reimbursement outcomes.

As part of the centralized governance group for payer and plan management, this lead role collaborates with Revenue Cycle, IT, Contracting, and operational teams, providing direction to ensure system configurations align with the Division of Financial Responsibilities (DOFR) models for health plans and medical groups. The role helps promote accountability, minimizes avoidable denials, and improves clean claim rates by leveraging data-driven insights and leading coordinated workflow improvements.

This position serves as a resource to support EDI operations for claims submission and remittance processing, providing guidance in issue identification and resolution (e.g., submission errors, acknowledgment failures, ERA discrepancies), and coordinating with clearinghouses, payers, and internal teams to ensure timely and accurate electronic data exchange.

This position contributes to enterprise-wide initiatives by analyzing payer behavior, identifying systemic issues, and leading the design and implementation of solutions that enhance claim transmission and adjudication processes. The role requires advanced knowledge of payer and plan data structures, claim lifecycle workflows, and downstream impacts across multiple entities, including UCSF Hospital Billing (HB), Professional Billing (PB), Home Health, Langley Porter, UCSF Benioff Physicians, Marin, Hyde, and Stanyan, as well as Community Connect affiliates.

Requirements:

• Bachelor's degree in a related area and/or equivalent experience.

• Five or more years of relevant experience.

• Three years or more years of experience in healthcare revenue cycle operations, including Epic system support and EDI processes.

• In-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.

• Advanced organizational and project management skills, and the ability to lead a team, prioritize tasks, and see projects through from inception to completion on schedule.

• Advanced skills in report development, dashboard design, and various software tools specific to healthcare revenue cycle management. Skills in common database, spreadsheet, and presentation software.

• Advanced communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to prepare compelling and informative reports and presentations to all levels of staff and management.

• Advanced analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems in revenue cycle program areas, to identify weaknesses and develop innovative solutions and process improvements.

• Advanced interpersonal skills, with the ability to collaborate effectively on highly complex projects in a team environment with a wide variety of business and clinical areas.

• Ability to work one or more days a week in Oakland based on business needs.

Preferences:

• Strong ability to advise management, serving as a technical expert, providing proposals for improvement and guidance on regulatory changes, industry trends, and developments in revenue cycle management.

• In-depth understanding of the issues, processes, reporting instruments, metrics, dashboard design, and other tools and techniques involved with measuring and analyzing the revenue cycle.

• EPIC Hospital Billing Certification.

• EPIC Clarity Certification.

Requirements:

• Bachelor's degree in a related area and/or equivalent experience.

• Five or more years of relevant experience.

• Three years or more years of experience in healthcare revenue cycle operations, including Epic system support and EDI processes.

• In-depth knowledge of the practices, procedures, and concepts of the healthcare revenue cycle and its component operations, including billing, collections, charge capture, contractual adjustments, third-party reimbursements, and cash management.

• Advanced organizational and project management skills, and the ability to lead a team, prioritize tasks, and see projects through from inception to completion on schedule.

• Advanced skills in report development, dashboard design, and various software tools specific to healthcare revenue cycle management. Skills in common database, spreadsheet, and presentation software.

• Advanced communications skills, with the ability to interpret and convey complex clinical finance information in a clear, concise manner. Ability to prepare compelling and informative reports and presentations to all levels of staff and management.

• Advanced analytical and problem-solving skills, with the ability to evaluate the effectiveness of workflows and systems in revenue cycle program areas, to identify weaknesses and develop innovative solutions and process improvements.

• Advanced interpersonal skills, with the ability to collaborate effectively on highly complex projects in a team environment with a wide variety of business and clinical areas.

• Ability to work one or more days a week in Oakland based on business needs.

Preferences:

• Strong ability to advise management, serving as a technical expert, providing proposals for improvement and guidance on regulatory changes, industry trends, and developments in revenue cycle management.

• In-depth understanding of the issues, processes, reporting instruments, metrics, dashboard design, and other tools and techniques involved with measuring and analyzing the revenue cycle.

• EPIC Hospital Billing Certification.

• EPIC Clarity Certification.