AmeriHealth Caritas · 1 day ago
Revenue Cycle Analyst
Newtown Square, PA
Full-time
Hybrid
Entry, Mid Level
1+ years expAmeriHealth Caritas is seeking a Revenue Cycle Analyst responsible for the accurate and timely preparation and analysis of financial reconciliations and premium payment files. The role involves managing and manipulating data, preparing reports, and ensuring compliance with state requirements.
Health CareInformation Technology
Responsibilities
Analyze and interpret financial data from sources such as 834 enrollment, membership, and maternity events; payment/financial files; Lock-in files; Jiva; Data Warehouse; Dats Lake; and the Facets System to identify discrepancies, determine the best approach to resolution
Maintains and creates databases, queries, joins, tables, and forms; designs and creates SQL queries and stored procedures, technical specifications, and user-defined functions, writing functional and technical specification documents
Prepare and maintain discrepancy reports, state reporting, and other plan-specific financial reporting to identify, reconcile, and control variances for maximum profitability
Generates and updates reports for monthly reconciliation, financial audits, and all other required reporting; Analyzes completed reports to ensure there are no material differences that should be escalated to management for review
Become familiar with and understand existing and new 834 (enrollment/membership) and 820, 835, 837 (payment/financial) companion guides, system notices, and member documentation, adherence to requirements; advise management on needed actions to comply with state requirements
Responsible for meeting all monthly and quarterly deadlines and providing full support to other areas such as Accounting, EDI, Enrollment, Encounters, Statutory, and the Actuarial departments
Participates in the completion of all designated annual goals for the Financial Services department
Support stakeholders explorations and information requests within departmental timeframes
Prepared for onsite audits of all tasks requiring process explanation and accountability
Qualification
Required
High School/GED required
1 to 3 Revenue Code Mapping, Data Analysis, Data warehousing, translated 5010 EDI files, financial reporting, electronic remittance advice (codes), and related financial analysis experience
Proficient in Databricks, Microsoft SQL Server, Oracle, MySQL, and SQL Server Reporting Services
Solid analytical skills and problem-solving skills with the ability to articulate and communicate recommendations for enhancement
Strong working knowledge of business computer programs, applications, and systems, database structures, and data files required
Strong communication (both written and verbal), analytical, and problem-solving skills
Strong organizational skills with the ability to coordinate several projects simultaneously
The ability to work on multiple tasks with competing priorities demonstrates strong subject matter expertise in the states and business processes that they support
Ability to work accurately and independently as well as comfortable interacting collaboratively with all levels of business; open-minded to consider alternative ideas and next steps for remediation
Preferred
Bachelor's degree preferred
2 years of experience in healthcare finance and/or financial reporting, preferred
Proficiency in Excel, Access, and Monarch preferred
An understanding of clinical coding or claims processing is preferred
Company
AmeriHealth Caritas
AmeriHealth Caritas is the health care solutions provider for those in most need and the chronically ill.
10001+ employees
H1B Sponsorship
AmeriHealth Caritas has a track record of offering H1B sponsorships. Please note that this does not
guarantee sponsorship for this specific role. Below presents additional info for your
reference. (Data Powered by US Department of Labor)
Distribution of Different Job Fields Receiving Sponsorship
Represents job field similar to this job
Trends of Total Sponsorships
2025 (18)
2024 (17)
2023 (12)
2022 (14)
2021 (4)
2020 (11)
Funding
Current Stage
Late StageLeadership Team
Kathleen Giblin
SVP Clinical Operations
Ash Hanson
Executive Vice President & Chief Human Resources Officer
Recent News
2025-11-06
The Philadelphia Inquirer
2025-10-02
2025-10-01
Company data provided by crunchbase