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.

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