Job Description

Senior Analyst, Revenue Recovery

This role serves as a subject matter expert in healthcare revenue recovery, focused on maximizing insurance reimbursement and identifying payment discrepancies. You will analyze contractual reimbursement terms, remittance data, underpayments, denials, and other revenue cycle opportunities. The position combines financial analysis, payer communication, problem solving, and cross-functional collaboration across healthcare revenue operations. You will investigate root causes, support timely recovery, and identify trends that can improve revenue cycle performance. The role also involves supporting escalations, leadership initiatives, and client-focused projects in a KPI-driven environment. This is a fully remote opportunity for an experienced revenue cycle professional who can work independently while serving as a mentor and resource for others.

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.

Job Tags

Similar Jobs