Revenue Cycle Support Analyst

PHMC serves as both a direct service provider to individuals, families, and communities across the region and an intermediary agent—managing large-scale contracts, government and philanthropic partnerships, and multidisciplinary initiatives that require operational sophistication, strategic leadership, and deep mission alignment.

COMPONENT: Revenue Cycle / Clinic Operations

 DIVISION: Accounting

LOCATION: 1500 Market Street

REPORTS TO: Clinic Revenue Cycle Liaisons supporting Dental, Medical, and Behavioral Health services 

FTE Status-Full-Time

Position Summary 

The PHMC Revenue Cycle Support Analyst provides dedicated analytical and operational support to the Revenue Cycle Liaisons across dental, medical, and behavioral health services. Key responsibilities include focused revenue cycle analysis, operational follow-up, KPI reporting, patient billing inquiries, insurance payer outreach, self-pay and patient responsibility reviews, and sliding fee screening and documentation. The role supports the liaison team by managing defined analytical, follow-up, and issue-resolution activities while maintaining visibility into clinic-level revenue cycle performance. 

The position serves as a bridge between PHMC clinic operations, Revenue Cycle Liaisons, ASP, insurance payers, and patient-facing staff to help identify workflow gaps, resolve recurring issues, support timely escalation, and improve patient financial experience. 

Essential Duties and Responsibilities:

• Provide direct operational and analytical support to PHMC Revenue Cycle Liaisons across dental, medical, and behavioral health clinic service lines, including patient access, registration accuracy, eligibility verification, patient responsibility review, and billing readiness. 

• Support Revenue Cycle Liaisons by conducting focused analysis, researching account-level issues, identifying trends and root causes, summarizing findings, and following assigned worklists and action items through resolution or appropriate escalation. 

• Perform self-pay charge and patient responsibility reviews, including balances, expected patient liability, sliding fee or discount application, insurance eligibility opportunities, and potential account corrections requiring escalation. 

• Support sliding fee screening workflows by reviewing whether eligible self-pay patients and commercially insured patients with higher cost-sharing amounts have been identified, offered appropriate sliding fee application information, and routed for completion in accordance with PHMC policy and FQHC requirements. 

• Identify accounts where sliding fee application, discount application, or patient responsibility calculations may not align with documented eligibility and escalate discrepancies to the appropriate PHMC Revenue Cycle Liaison, billing team, or clinic resource for review and correction. 

• Support PHMC’s revenue cycle performance monitoring by running recurring KPI reports, validating outputs, preparing clinic-level summaries, identifying trends, and escalating performance concerns to the appropriate Revenue Cycle Liaison. 

• Track, research, and help resolve revenue cycle issues related to eligibility, coordination of benefits, claim edits, denials, missing documentation, payer requirements, coding feedback, payment posting, and accounts receivable follow-up. 

• Conduct insurance payer outreach by contacting payer representatives, submitting inquiries, obtaining claim or authorization status updates, clarifying benefit or eligibility questions, documenting responses, and escalating unresolved issues to the appropriate PHMC Revenue Cycle Liaison or billing resource. 

• Maintain issue trackers, worklists, escalation logs, and status updates to support timely resolution of items affecting claim submission, reimbursement, and patient account accuracy. 

• Review revenue cycle reports and dashboards, including insurance verification rate, clean claim rate, denial trends, accounts receivable aging, point-of-service collections, no-show rate, and front-desk quality assurance results. 

• Prepare recurring revenue cycle performance updates for clinic leadership, revenue cycle leadership, and liaison teams, highlighting trends, open issues, barriers, root causes, and recommended follow-up actions. 

• Run, compile, and distribute recurring revenue cycle KPI reports for dental, medical, and behavioral health service lines, including clinic-level performance summaries, trend analysis, and supporting detail for liaison review. 

• Validate KPI reporting outputs for accuracy and completeness by reconciling report totals, reviewing outliers, identifying missing data, and escalating potential data integrity concerns to the appropriate liaison, billing team, or system owner. 

• Track KPI performance against established targets, identify unfavorable trends or recurring gaps, and summarize key drivers for discussion with Clinic Revenue Cycle Liaisons and operational leadership. 

• Develop and maintain reporting calendars, distribution lists, meeting materials, and follow-up documentation to support timely review of revenue cycle performance and outstanding operational issues. 

• Escalate urgent or recurring revenue cycle issues through the appropriate pathway, including payer-related barriers, system access or configuration issues, workflow breakdowns, unresolved denials, claim submission delays, and clinic documentation gaps. 

• Support staff education by helping develop job aids, process reminders, workflow guides, scripting tools, and refresher training materials for front-desk and clinic team members. 

• Assist with onboarding and ongoing coaching efforts related to registration standards, insurance verification workflows, sliding fee application processes, patient responsibility conversations, and payer-specific requirements. 

• Coordinate with billing teams, external vendors, clearinghouses, and payer representatives as directed to request information, follow up on outstanding items, and support resolution of operational issues. 

• Identify recurring revenue cycle issues, front-end errors, and denial root causes; communicate patterns and recommend workflow or process improvements to the appropriate Clinic Revenue Cycle Liaison for education, escalation, or process redesign. 

• Support compliance with organizational policies, FQHC requirements, payer guidelines, privacy requirements, and documentation standards related to patient registration, billing, collections, financial assistance, and sliding fee processes. 

• Participate in recurring revenue cycle meetings, denials prevention discussions, clinic operations huddles, workgroup sessions, and performance improvement initiatives. 

• Perform other duties as assigned to support revenue cycle performance, operational consistency, and patient financial experience. 

 Key Areas of Focus 

 Minimum Qualifications 

• High school diploma or equivalent required; associate degree or bachelor’s degree in healthcare administration, business, finance, public health, or a related field preferred. 

• Two or more years of experience in healthcare revenue cycle, patient access, billing, registration, eligibility verification, claims follow-up, patient billing inquiry resolution, dental billing, behavioral health billing, or clinic operations is required. 

• Experience working in an FQHC, community health center, ambulatory clinic, dental clinic, behavioral health setting, or multi-specialty practice environment preferred. 

• Working knowledge of payer requirements, insurance eligibility, coordination of benefits, prior authorization, sliding fee scale processes, patient collections, self-pay account review, patient responsibility calculations, claim edits, denials, and accounts receivable follow-up. 

• Familiarity with FQHC sliding fee discount program concepts, including screening, application documentation, income and household size review, patient communication, discount application, and escalation of documentation or account discrepancies. 

• Proficiency with electronic health records, practice management, billing, clearinghouse, payer portal, and Microsoft Office applications. 

• Ability to organize multiple priorities, maintain accurate tracking tools, follow through on open items, and communicate status updates clearly. 

Preferred Skills and Competencies 

• Strong understanding of front-end revenue cycle workflows and how registration, eligibility, authorization, and documentation accuracy affect reimbursement and denials. 

• Ability to analyze recurring issues, identify root causes, and escalate trends to the appropriate liaison or leader. 

• Strong written and verbal communication skills, including the ability to interact professionally with clinic staff, billing teams, leadership, external vendors, and patients when needed. 

• Meticulous approach to tracking, documentation, follow-up, and data validation. 

• Comfortable working across multiple service lines and adapting to the unique requirements of dental, medical, and behavioral health workflows. 

• Collaborative, service-oriented mindset with the ability to support staff education and reinforce standardized processes positively and constructively. 

• Ability to communicate sliding fee and patient responsibility information in a clear, respectful, and patient-centered manner while staying within approved PHMC scripting, policy, and role guidelines. 

• Ability to maintain confidentiality and comply with HIPAA, organizational policies, and applicable regulatory requirements.

PHMC is an Equal Opportunity and E-Verify Employer.