Business Intelligence Analyst

Description :

The core responsibilities for the job include the following :

Business Analysis and 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 and 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 and 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 and 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 and 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.