Healthcare Business Analyst

Healthcare Business Analyst –

6 -12 Months contract –   extension   

Vienna, VA

 Job Description:

• We are seeking a Healthcare Business Analyst with 5+ years of Business Analyst experience and strong expertise in Revenue Cycle Management (RCM).
• The ideal candidate should have experience with patient registration, insurance verification, medical billing, coding, claims processing, denials management, payment posting, and accounts receivable.
• Experience with Epic/Cerner, requirements gathering, Agile, UAT, SQL, and knowledge of HIPAA and healthcare regulations is preferred. Strong communication and stakeholder management skills are required.

Key Responsibilities

• Analyze and document business requirements for Revenue Cycle Management (RCM) initiatives.
• Work closely with stakeholders, clinical teams, billing departments, and IT teams to improve revenue cycle processes.
• Gather, analyze, and document functional and technical requirements.
• Create Business Requirement Documents (BRDs), Functional Requirement Documents (FRDs), process flows, user stories, and acceptance criteria.
• Evaluate existing workflows and recommend process improvements to maximize revenue and operational efficiency.
• Support patient registration, insurance verification, authorization, charge capture, coding, billing, claims management, payment posting, denials management, and collections.
• Coordinate User Acceptance Testing (UAT), system integration testing, and production validation.
• Analyze KPIs and revenue cycle metrics, including Days in A/R, Clean Claim Rate, Denial Rate, Net Collection Rate, and First Pass Resolution Rate.
• Collaborate with project managers, developers, QA teams, and vendors throughout the SDLC.
• Ensure compliance with HIPAA, CMS, Medicare, Medicaid, and commercial payer regulations.
• Support system implementations, upgrades, and process optimization initiatives.