Senior Analyst, Revenue Recovery

Accountabilities:

• Analyze contractual reimbursement arrangements and identify variances between expected reimbursement and payments received from managed care, government, and other payors.
• Communicate directly with payors regarding outstanding underpayments, file appeals, resolve account variances, and support timely and accurate recovery.
• Review large volumes of remittance and account data to identify underpayments, billing opportunities, trends, and opportunities for revenue optimization.
• Investigate the root causes of underpayments, denials, and delayed payments and collaborate with client teams to document and address recurring issues.
• Maintain a thorough understanding of applicable state and federal insurance regulations and payor-specific requirements when determining appropriate recovery actions.
• Accurately document investigative and recovery activities in client host systems, revenue cycle platforms, and other designated tracking tools.
• Analyze trends and compile reports to communicate findings, risks, issues, and recommendations to leadership.
• Collaborate with Managed Care, Billing, Coding, Revenue Integrity, Payor Strategy, and other departments to resolve complex revenue cycle issues.
• Assist leadership with client and payor escalations, strategic initiatives, reports, and assigned projects.
• Demonstrate strong problem-solving and critical-thinking skills when determining effective approaches to complex underpayments.
• Apply knowledge of underpayment prediction rules and related revenue recovery tools to identify accounts requiring further investigation.
• Manage multiple projects, reports, and priorities efficiently in a fast-paced, KPI-driven environment while meeting established productivity and quality standards.
• Provide guidance and mentorship to other team members and serve as a subject matter expert on revenue recovery processes.

Requirements

• At least 5 years of experience in the hospital or physician insurance industry, healthcare revenue cycle, or a closely related field.
• Demonstrated understanding of healthcare revenue cycle processes and experience identifying and recovering underpaid accounts.
• High school diploma or GED required; a Bachelor's degree is preferred but not required.
• CRCR (Certified Revenue Cycle Representative) certification required within 9 months of hire.
• Strong knowledge of insurance reimbursement, contractual variances, underpayments, denials, and payer processes.
• Excellent verbal and written communication skills, with the ability to explain complex findings clearly to internal and external stakeholders.
• Strong analytical, problem-solving, and critical-thinking capabilities.
• Ability to adapt to multiple client host systems and work effectively across different operational environments.
• Proficiency with Microsoft Office applications and the ability to work with large amounts of data and reports.
• Strong customer service orientation and professional presence.
• High level of integrity, honesty, accountability, and attention to detail.
• Self-motivated and able to work independently while effectively collaborating with cross-functional teams.
• Ability to manage multiple priorities, projects, and deadlines in a fast-paced environment.
• Experience mentoring colleagues or serving as a subject matter expert is valuable.

Benefits

• Annual compensation of $66,300–$99,450, depending on experience and other job-related factors.
• Bonus and incentive opportunities.
• Paid professional certifications, including support toward the required CRCR certification.
• Tuition reimbursement.
• Comprehensive healthcare and benefits package.
• Retirement benefits.
• Paid time off and well-being programs.
• Fully remote, work-from-home opportunity within the United States.
• Professional development and career advancement opportunities.
• Opportunities to work on complex healthcare revenue cycle, reimbursement, analytics, and recovery initiatives.
• Cross-functional collaboration with Managed Care, Billing, Coding, Revenue Integrity, and Payor Strategy teams.
• Opportunity to serve as a subject matter expert and mentor other revenue cycle professionals.
• Culture focused on collaboration, innovation, professional growth, and work-life flexibility.
• Quarterly and annual incentive programs based on performance and contributions.
• Position is limited to individuals residing in and authorized to work within the United States.