BI Developer – RCM

The Business Intelligence (BI) Analyst will be responsible for transforming raw healthcare and financial data into clear, actionable insights and will develop interactive dashboards and reports that empower operational leaders, client services teams, and executive decision-makers to monitor revenue cycle performance, identify gaps, and take corrective action. The Business Intelligence (BI) Analyst will play a vital role in integrating business logic, visual storytelling, and data-driven strategies into RCM Solutions.

Key Responsibilities

Business Analysis & Performance Monitoring :

 Evaluate trends in denial codes, claim rejections, and underpayments to identify process improvement opportunities.

 Track payer-wise behaviour, including turnaround time, rejection rates, and appeal effectiveness, to optimize payer relations.

 Perform variance analysis between expected vs. actual collections at the CPT, provider, or facility level.

 Conduct root cause analysis on recurring AR issues and collaborate with the Engineering team to build analytics within the product to address inefficiencies.

 Provide comparative benchmarking analysis across clients, facilities, or billing teams to identify high and low performers.

 Analyse operational data to uncover gaps in performance and revenue leakage.

 Monitor team productivity, payment velocity, and claim lifecycle metrics to enable proactive management.

 Build and automate monthly and quarterly performance reports for internal review and client delivery.

 Support the creation of early warning systems using thresholds and alerts to flag potential revenue risks before they escalate.

Data Modelling & Reporting Optimization :

 Build optimized data models and star schemas for efficient querying and reporting.

 Ensure data integrity, accuracy, and consistency across all reports and dashboards.

 Design and maintain semantic layers and calculated measures to standardize KPIs across reports.

 Develop performance-tuned data models to handle large datasets from EMRs, clearinghouses, and payer feeds.

 Work with data engineering and ETL teams to define data transformation logic and join relationships between tables.

 Conduct periodic audits and validations to ensure report outputs match source system data.

 Create data dictionaries and metadata documentation to support self-service BI and cross-functional reporting adoption.

Client-Facing Reporting :

 Create client-specific dashboards aligned with contractual SLAs, performance KPIs, and custom reporting formats.

 Participate in client calls, review meetings, or QBRs to explain BI findings, answer queries, and gather feedback for improvements.

 Tailor reports to meet the unique operational and financial goals of each client based on their specialty (e.g., radiology, physical therapy, behavioral health).

 Support onboarding of new clients by designing initial reporting templates and walkthroughs based on contractual agreements.

 Collaborate with client-facing teams to identify and implement report automation and scheduling based on client preferences.

 Maintain a repository of client reporting templates and historical performance data to support renewals, audits, and strategic discussions.

Collaboration & Cross-Functional Support :

 Partner with Data Analysts to integrate deeper insights (e.g., predictive denial risk models, claim lag analytics) into business dashboards.

 Work closely with Client Services Managers to understand specific client expectations and customize reporting accordingly.

 Collaborate with the technology team to align data infrastructure, APIs, data refresh schedules, and build Technology for RCM.

Dashboard Development & Visualization :

 Design, develop, and maintain interactive dashboards and reports using BI tools (Power BI, Tableau, QlikView, or Looker).

 Visualize trends across critical RCM KPIs such as denial rates, net collection rate, clean claim rate, first-pass resolution, and AR >

90 days.

 Create intuitive, user-friendly interfaces with filter-based drilldowns (by payer, provider, region, facility, CPT, etc.).

 Develop dynamic and parameterized dashboards that allow stakeholders to customize views based on their specific needs.

 Incorporate visual indicators and alerts (color codes, trend arrows, threshold flags) to help users quickly interpret performance issues.

 Ensure dashboards are responsive and optimized for various screen sizes and devices, especially for client-facing reports.

 Perform regular updates and enhancements to dashboards based on evolving client requirements, stakeholder feedback, or data model changes.

Data Quality & Governance :

 Ensure accuracy, consistency, and security of healthcare data in compliance with HIPAA and company standards.

 Participate in ETL / data validation and cleansing tasks as required.