Revenue Data Analyst at UCSF

Emeryville, California, United States -

Full Time

Start Date

Immediate

Expiry Date

11 Sep, 26

Salary

90700.0

Posted On

13 Jun, 26

Experience

5 year(s) or above

Remote Job

Yes

Telecommute

Yes

Sponsor Visa

Skills

Revenue Cycle Management, Epic System Support, EDI Processes, Data Analysis, Project Management, Report Development, Dashboard Design, Claim Performance Management, Payer and Plan Management, Financial Reporting, Problem Solving, Interpersonal Communication

Industry

Hospitals and Health Care

Description

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.

Responsibilities

Leads revenue cycle functions and system billing oversight to ensure accurate data and optimal reimbursement. Manages the maintenance and governance of Insurance Master Files and drives improvements in claim accuracy and EDI operations.